Influence of an endotracheal tube with polyurethane cuff and subglottic secretion drainage on pneumonia.

Published on Dec 1, 2007in American Journal of Respiratory and Critical Care Medicine17.452
· DOI :10.1164/RCCM.200705-761OC
Leonardo Lorente37
Estimated H-index: 37
(Hospital Universitario de Canarias),
María Lecuona14
Estimated H-index: 14
+ 2 AuthorsAntonio Sierra17
Estimated H-index: 17
Sources
Abstract
Rationale: Subglottic secretion drainage (SSD) appears to be effective in preventing ventilator-associated pneumonia (VAP), primarily by reducing early-onset pneumonia; but it may not prevent late-onset pneumonia. We tested the hypothesis using an endotracheal tube incorporating an ultrathin polyurethane cuff (which reduces channel formation and fluid leakage from the subglottic area), in addition to an SSD lumen, which would reduce the incidence of late-onset VAP.Objectives: To compare the incidence of VAP, using an endotracheal tube with polyurethane cuff and subglottic secretion drainage (ETT-PUC-SSD) versus a conventional endotracheal tube (ETT-C) with polyvinyl cuff, without subglottic secretion drainage.Methods: Clinical randomized trial in a 24-bed medical–surgical intensive care unit. Patients expected to require mechanical ventilation for more than 24 hours were randomly assigned to one of two groups: one was ventilated with ETT-PUC-SSD and the other with ETT-C.Measurements and Main Results: Trac...
📖 Papers frequently viewed together
298 Citations
379 Citations
163 Citations
References22
Newest
#1Nasia Safdar (UW: University of Wisconsin-Madison)H-Index: 65
#2Cameron Dezfulian (Johns Hopkins University)H-Index: 22
Last. Sanjay SaintH-Index: 96
view all 4 authors...
Background:Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in critically ill patients. The clinical and economic consequences of VAP are unclear, with a broad range of values reported in the literatureObjective:To perform a systematic review to determine the incidence o
867 CitationsSource
#1Cameron Dezfulian (Johns Hopkins University)H-Index: 22
#2Kaveh G. Shojania (UCSF: University of California, San Francisco)H-Index: 53
Last. Sanjay Saint (UM: University of Michigan)H-Index: 96
view all 6 authors...
Purpose To assess the efficacy of subglottic secretion drainage in preventing ventilator-associated pneumonia. Methods We performed a comprehensive, systematic meta-analysis of randomized trials that have compared subglottic secretion drainage with standard endotracheal tube care in mechanically ventilated patients. Studies were identified by a computerized database search, review of bibliographies, and expert consultation. Summary risk ratios or weighted mean differences with 95% confidence int...
266 CitationsSource
#1Lorenzo Berra (NIH: National Institutes of Health)H-Index: 26
#2Lorenzo De Marchi (NIH: National Institutes of Health)H-Index: 5
Last. Theodor Kolobow (NIH: National Institutes of Health)H-Index: 35
view all 6 authors...
Objective:Continuous aspiration of subglottic secretions (CASS) is believed to lower the incidence of ventilator-associated pneumonia. Animal studies to establish safety and efficacy of CASS have not been conducted.Design:Prospective randomized animal study.Setting:Animal-research facility at the U.
105 CitationsSource
#1Peter Dodek (UBC: University of British Columbia)H-Index: 59
#2Sean P. KeenanH-Index: 43
Last. Christian Brun-BuissonH-Index: 96
view all 11 authors...
Peter Dodek, MD, MHSc; Sean Keenan, MD, MSc(Epid); Deborah Cook, MD, MSc(Epid); Daren Heyland, MD, MSc(Epid);Michael Jacka, MD, MSc; Lori Hand, RRT; John Muscedere, MD; Debra Foster, RN; Nav Mehta, MD; Richard Hall, MD; andChristian Brun-Buisson, MD, for the Canadian Critical Care Trials Group and the Canadian Critical Care Society
440 CitationsSource
#1Alexander Dullenkopf (Boston Children's Hospital)H-Index: 23
#2Achim Schmitz (Boston Children's Hospital)H-Index: 21
Last. Markus Weiss (Boston Children's Hospital)H-Index: 56
view all 5 authors...
SummaryBackground and objective:To compare the recently introduced Microcuff® endotracheal tube with conventional tubes in respect of the cuff pressures required to prevent air leakage.Methods:The following tubes (ID 7.0 mm) were compared: Microcuff® HVLP ICU, Mallinckrodt HiLo®, Portex Profile Soft
69 CitationsSource
#1Emmanuelle GirouH-Index: 30
#2Annie Buu-HoïH-Index: 14
Last. Jean-Yves FagonH-Index: 47
view all 7 authors...
Objective To evaluate the impact of continuous subglottic suctioning and semi-recumbent body position on bacterial colonisation of the lower respiratory tract.
89 CitationsSource
#1Alexander Dullenkopf (Boston Children's Hospital)H-Index: 23
#2Andreas C. Gerber (Boston Children's Hospital)H-Index: 31
Last. Markus Weiss (Boston Children's Hospital)H-Index: 56
view all 3 authors...
Objective This study compared the recently introduced Microcuff endotracheal tube HVLP ICU featuring an ultrathin (7-µm) polyurethane cuff membrane with endotracheal tubes from different manufacturers regarding fluid leakage past the tube cuff.
178 CitationsSource
#1Kees Smulders (Bosch)H-Index: 1
#2Hans van der Hoeven (Bosch)H-Index: 1
Last. Christina M. J. E. Vandenbroucke-Grauls (VU: VU University Amsterdam)H-Index: 87
view all 4 authors...
Objective To study the effect of subglottic secretions drainage on the incidence of ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. Design A randomized clinical trial. Setting A 12-bed general ICU. Patients One hundred fifty patients with an expected duration of mechanical ventilation > 72 h were enrolled in the study. Intervention Patients were randomly assigned to receive either an endotracheal tube for intermittent subglottic secretions drainage or a standa...
213 CitationsSource
#1Mark BluntH-Index: 16
#2Peter YoungH-Index: 31
Last. Alan HaddockH-Index: 1
view all 4 authors...
Background: Leakage of fluid occurs along the longitudinal folds within the wall of an inflated high-volume, low-pressure cuff. Theoretically, lubrication of the cuff with a water-soluble gel might prevent aspiration by plugging the channels in the cuff wall. Pulmonary aspiration during anesthesia has been linked with postoperative pneumonia and during critical illness causes ventilator-associated pneumonia. Methods: Lubricated cuffs were compared with nonlubricated cuffs for leakage of dye plac...
85 CitationsSource
#1Torres AH-Index: 1
#2Carlet JH-Index: 1
Last. Tobias WelteH-Index: 99
view all 2 authors...
This Task Force was supported and endorsed by the following Societies: European Respiratory Society, European Society of Intensive Care Medicine, European Society of Clinical Microbiology and Infectious Diseases and European Society of Anaesthesiology. ⇓In the last decade, considerable investigational efforts have been made in the field of the management of ventilator-associated pneumonia (VAP). Several studies have provided important insights into the relationship of histology and bacteriology ...
146 CitationsSource
Cited By200
Newest
We studied the application of a mobile terminal application program in endotracheal tube (ETT) cuff pressure measurement to improve the implementation rate of scientific ETT cuff pressure measurement and to ensure that the pressure falls within the recommended range. A pre-post controlled study lasting for 18 months was undertaken in a 40-bed general intensive care unit (GICU). This included a 6-month baseline period (baseline group) and a 6-month intervention period (intervention group). The mo...
Source
Last. François Philippart (CNRS: Centre national de la recherche scientifique)H-Index: 1
view all 5 authors...
Resumen Las principales infecciones nosocomiales (IN) representan un peligro especialmente importante en reanimacion, donde los pacientes son fragiles y estan expuestos a numerosos dispositivos invasivos. Las principales localizaciones expuestas al riesgo infeccioso son el pulmon, en particular en el marco de las neumonias adquiridas bajo ventilacion mecanica, las infecciones urinarias y las infecciones de cateteres. Su frecuencia y gravedad potenciales hacen imperativa la prevencion. Esta preve...
Source
#1Mauricio Orozco-Levi (UPF: Pompeu Fabra University)H-Index: 26
#2Karen Pedrozo Arias (Université de Sherbrooke)
Last. Alba Ramírez-Sarmiento (UPF: Pompeu Fabra University)H-Index: 15
view all 4 authors...
Resumen La broncoaspiracion del reflujo gastroesofagico (RGE) es uno de los principales factores de riesgo para la neumonia intrahospitalaria (NIH) y la neumonia asociada a la ventilacion mecanica (NAVM). En el ambito clinico de la vida real, la identificacion de las causas del RGE implica una complejidad diagnostica indiscutible, que varia a medida que el paciente esta bajo el cuidado critico. El RGE es modificable en estos pacientes, pero las intervenciones terapeuticas exigen la consideracion...
Source
Last. François Philippart (CNRS: Centre national de la recherche scientifique)H-Index: 1
view all 5 authors...
Riassunto Le principali infezioni nosocomiali (IN) rappresentano un pericolo particolarmente significativo in terapia intensiva, dove i pazienti sono fragili ed esposti a molti dispositivi invasivi. I principali siti esposti al rischio di infezione sono il polmone, in particolare nelle polmoniti acquisite sotto ventilazione meccanica, le infezioni urinarie e le infezioni da catetere. Le loro frequenze e la loro gravita potenziale rendono imperativa la loro prevenzione. Questa prevenzione richied...
Source
#1Minami Saito (Teikyo University)
#2Koichi Maruyama (Teikyo University)H-Index: 7
Last. Tomio Andoh (Teikyo University)H-Index: 4
view all 6 authors...
BACKGROUND The aim of this meta-analysis with trial sequential analysis (TSA) was to evaluate the effect of a polyurethane (PU) tracheal tube cuff on the prevention of ventilator-associated pneumonia (VAP). METHODS We performed a systematic search using the MEDLINE database through PubMed, Cochrane Central Register of Controlled Trial, SCOPUS, and Web of Science.Randomized controlled trials comparing the incidence of VAP and clinically relevant outcomes between PU cuff tubes and polyvinyl chlori...
Source
#1Pramanik S (Indian Institute of Technology Madras)
view all 5 authors...
BackgroundThe Indian Biomedical Device Industry has been growing at an unprecedented rate, but several hindrances need to be acknowledged in offering access to quality, budget-friendly medical devices in India. This article explores the current loopholes of the Indian biomedical device industry along with the proposal of various innovative solutions, with emphasis on ventilators. MethodsAn online survey with the help of Google forms was conducted from 1st November to 25th December 2020, addressi...
Source
Ventilator-associated pneumonia (VAP) is a common cause of morbidity and mortality in intensive care unit (ICU), and among the several preventative strategies described to reduce the incidence of V...
Source
Source
Uvod: Pneumonie je u pacientů s umělou plicni ventilaci nejcastějsi pozorovanou infekcni komplikaci na jednotce intenzivni pece. Cilem prace bylo zhodnotit dodržovani postupů pro prevenci ventilatorove pneumonie v klinicke praxi na Klinice anestezie, resuscitace a intenzivni mediciny ve Fakultni nemocnici Ostrava (KARIM FNO). Dilci cile byly zaměřeny na zhodnoceni výskytu ventilatorove pneumonie a posouzeni efektu zavedeneho checklistu pro prevenci ventilatorove pneumonie v klinicke praxi. Metod...
Source
#1Denise Battaglini (University of Barcelona)H-Index: 11
#2Chiara RobbaH-Index: 24
Last. Paolo Pelosi (UFRJ: Federal University of Rio de Janeiro)H-Index: 100
view all 13 authors...
In late 2019, an outbreak of a novel human coronavirus causing respiratory disease was identified in Wuhan, China. The virus spread rapidly worldwide, reaching pandemic status. Chest computed tomography scans of patients with coronavirus disease-2019 (COVID-19) have revealed different stages of respiratory involvement, with extremely variable lung presentations, which require individualized ventilatory strategies in those who become critically ill. Chest physiotherapy has proven to be effective ...
9 CitationsSource