Igor Muzlovic1, Janja Perme1, David Stubljar2. 1. Department of Infectious Diseases, University Medical Centre, Zaloška 2, Ljubljana, Slovenia. 2. In-Medico-Research & Development, Mestni trg 11, Metlika, Slovenia. d.stubljar@gmail.com.
Abstract
PURPOSE: The aim of the study was to investigate whether polyurethane (PU) endotracheal tubes, continuous measurements of cuff pressure and aspiration of the subglottic space as a bundle of parameters could reduce patients' risk for developing ventilator associated pneumonia (VAP). METHODS: Two groups of patients that differed only in terms of endotracheal tubes and intubation intervention were compared. Group A was ventilated using PU tubes a with conical cuff; they also had continuous cuff pressure measurement and continuous subglottic aspiration. Group B was ventilated using PVC tubes with a cylindrical cuff; the patients underwent intermittent cuff pressure measurement and intermittent subglottic aspiration. RESULTS: Seven patients in group A (13.2%) and 18 in group B (36.0%) out of 103 were diagnosed with VAP. VAP patients were in general older, stayed longer in the ICU and were ventilated significantly longer compared with the patients with no VAP. Eight more patients in group B died compared with group A. Moreover, subjects in group A survived longer. Patient age, hours on mechanical ventilation, and days on an ICU were all positively associated with the occurrence of VAP. CONCLUSIONS: Prevention parameters in ventilation (PU cuff, conical cuff, continuous subglottic drainage and continuous cuff pressure measurement) could prevent the incidence of VAP in ICU patients.
RCT Entities:
PURPOSE: The aim of the study was to investigate whether polyurethane (PU) endotracheal tubes, continuous measurements of cuff pressure and aspiration of the subglottic space as a bundle of parameters could reduce patients' risk for developing ventilator associated pneumonia (VAP). METHODS: Two groups of patients that differed only in terms of endotracheal tubes and intubation intervention were compared. Group A was ventilated using PU tubes a with conical cuff; they also had continuous cuff pressure measurement and continuous subglottic aspiration. Group B was ventilated using PVC tubes with a cylindrical cuff; the patients underwent intermittent cuff pressure measurement and intermittent subglottic aspiration. RESULTS: Seven patients in group A (13.2%) and 18 in group B (36.0%) out of 103 were diagnosed with VAP. VAP patients were in general older, stayed longer in the ICU and were ventilated significantly longer compared with the patients with no VAP. Eight more patients in group B died compared with group A. Moreover, subjects in group A survived longer. Patient age, hours on mechanical ventilation, and days on an ICU were all positively associated with the occurrence of VAP. CONCLUSIONS: Prevention parameters in ventilation (PU cuff, conical cuff, continuous subglottic drainage and continuous cuff pressure measurement) could prevent the incidence of VAP in ICU patients.
Authors: Steven Deem; David Yanez; Laura Sissons-Ross; Jo Ann Elrod Broeckel; Stephen Daniel; Miriam Treggiari Journal: Ann Am Thorac Soc Date: 2016-01
Authors: Alberto Zanella; Massimo Cressoni; Myra Epp; Mario Stylianou; Theodor Kolobow Journal: Intensive Care Med Date: 2008-02-08 Impact factor: 17.440
Authors: Steven A Frost; Azmeen Azeem; Evan Alexandrou; Victor Tam; Jeffrey K Murphy; Leanne Hunt; William O'Regan; Ken M Hillman Journal: Aust Crit Care Date: 2013-04-11 Impact factor: 2.737
Authors: P Bulpa; P Evrard; S Bouhon; F Schryvers; J Jamart; I Michaux; A Dive; T Vander Borght; B Krug Journal: Minerva Anestesiol Date: 2013-03-19 Impact factor: 3.051
Authors: Denise Battaglini; Chiara Robba; Andrea Fedele; Sebastian Trancǎ; Samir Giuseppe Sukkar; Vincenzo Di Pilato; Matteo Bassetti; Daniele Roberto Giacobbe; Antonio Vena; Nicolò Patroniti; Lorenzo Ball; Iole Brunetti; Antoni Torres Martí; Patricia Rieken Macedo Rocco; Paolo Pelosi Journal: Front Med (Lausanne) Date: 2021-06-04