Ballotability of cuff to confirm the correct intratracheal position of the endotracheal tube in the intensive care unit

The cuff ballotability method was used in 120 adult patients to confirm the correct depth of insertion of the endotracheal tube after tracheal intubation. The correct tube position was assumed when the cuff of the endotracheal tube could be felt to distend over the suprasternal notch when the pilot balloon was squeezed and the pilot balloon was felt to distend when pressure was applied over the suprasternal notch. Chest radiography was performed later to confirm the position of the endotracheal tube. In all patients the tip of the endotracheal tube was found to be in the desired position, i.e. 3-7 cm from the carina - the level of T3-T4 vertebrae. We concluded this technique to be a simple and reproducible way to confirm the correct depth of insertion of endotracheal tubes.