Endotracheal Tube Intracuff Pressure Changes in Patients Transported by a Helicopter Emergency Medical Service: A Prospective Observational Study

•During helicopter transport, the pressure within a cuffed endotracheal tube is subject to decreases in atmospheric pressure, which may cause the cuff to overinflate.•The median initial cuff pressure before takeoff was 35 cm H2O (interquartile range, 24-50 cm H2O), which increased to 50 cm H2O (interquartile range, 35-70 cm H2O) at maximum altitude.•A total of 169 patients (81.3%) had a cuff pressure > 30 cm H2O at maximum altitude.•Further research is required to determine if exposure to transient increases in cuff pressure for short durations is clinically significant.