Efficiency of a pneumatic device in controlling cuff pressure of polyurethane-cuffed tracheal tubes: a randomized controlled study

BMC Anesthesiology

Research Article

Farid Zerimech¹  Malika Balduyck²  Julien De Jonckheere³  Emmanuelle Jaillette⁴  Saad Nseir⁵  Alain Durocher⁵  Alain Duhamel⁶  Demosthenes Makris⁷ 

[1] Biochemistry and Molecular Biology Laboratory, Biochemistry Division, Pathology and Biology Center, University Hospital of Lille, 59037, Lille cedex, France;Biochemistry and Molecular Biology Laboratory, Biochemistry Division, Pathology and Biology Center, University Hospital of Lille, 59037, Lille cedex, France;Biochemistry and Molecular Biology Laboratory, Faculty of Pharmacy, Lille II University, 1 place de Verdun, 59045, Lille, France;Clinical Investigation Center - Innovative Technologies, INSERM CIC-IT 807, University Hospital of Lille, 152 rue du Dr Alexandre Yersin, 59120, Loos, France;Critical Care Center, R. Salengro Hospital, University Hospital of Lille, Rue E. Laine, 59037, Lille cedex, France;Critical Care Center, R. Salengro Hospital, University Hospital of Lille, Rue E. Laine, 59037, Lille cedex, France;Medical Assessment Laboratory, EA 2694, Nord de France University, 1 place de Verdun, 59045, Lille, France;Epidemiology, Public Health and Quality of Care, Nord-de-France University, Lille, France;Intensive Care Unit, University Hospital of Larisa, University of Thessaly, Biopolis Street, 41110, Larisa, Greece;

关键词: Intubation;    Polyurethane;    Tracheal cuff;    Microaspiration;    Tracheal injury;    Pneumonia;   

DOI  :  10.1186/1471-2253-13-50

 received in 2013-03-31, accepted in 2013-12-18,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThe primary objective of this study was to determine the efficiency of a pneumatic device in controlling cuff pressure (Pcuff) in patients intubated with polyurethane-cuffed tracheal tubes. Secondary objectives were to determine the impact of continuous control of Pcuff, and cuff shape on microaspiration of gastric contents.MethodsProspective randomized controlled study. All patients requiring intubation and mechanical ventilation ≥48 h were eligible. The first 32 patients were intubated with tapered polyurethane-cuffed, and the 32 following patients were intubated with cylindrical polyurethane-cuffed tracheal tubes. Patients randomly received 24 h of continuous control of Pcuff using a pneumatic device (Nosten®), and 24 h of routine care of Pcuff using a manometer. Target Pcuff was 25 cmH2O. Pcuff was continuously recorded, and pepsin was quantitatively measured in all tracheal aspirates during these periods.ResultsThe pneumatic device was efficient in controlling Pcuff (med [IQ] 26 [24, 28] vs 22 [20, 28] cmH2O, during continuous control of Pcuff and routine care, respectively; p = 0.017). In addition, percentage of patients with underinflation (31% vs 68%) or overinflation (53% vs 100%) of tracheal cuff, and percentage of time spent with underinflation (0.9 [0, 17] vs 14% [4, 30]) or overinflation (0 [0, 2] vs 32% [9, 54]) were significantly (p < 0.001) reduced during continuous control of Pcuff compared with routine care.No significant difference was found in microaspiration of gastric content between continuous control of Pcuff compared with routine care, or between patients intubated with tapered compared with cylindrical polyurethane-cuffed tracheal tubes.ConclusionThe pneumatic device was efficient in controlling Pcuff in critically ill patients intubated with polyurethane-cuffed tracheal tubes.Trial registrationThe Australian New Zealand Clinical Trials Registry (NCT01351259)

【 授权许可】

Unknown   
© Jaillette et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.