NDLI: Continuous control of endotracheal cuff pressure and tracheal wall damage: a randomized controlled animal study

Content Provider	Springer Nature : BioMed Central
Author	Nseir, Saad Duguet, Alexandre Copin, Marie-Christine De Jonckheere, Julien Zhang, Mao Similowski, Thomas Marquette, Charles-Hugo
Abstract	Background Intubation is frequently performed in intensive care unit patients. Overinflation of the endotracheal tube cuff is a risk factor for tracheal ischemia and subsequent complications. Despite manual control of the cuff pressure, overinflation of the endotracheal cuff is common in intensive care unit patients. We hypothesized that efficient continuous control of the endotracheal cuff pressure using a pneumatic device would reduce tracheal ischemic lesions in piglets ventilated for 48 hours through a high-volume, low-pressure endotracheal tube. Materials and methods Twelve piglets were intubated and mechanically ventilated for 48 hours. Animals were randomized to manual control of the endotracheal cuff pressure (n = 6) or to continuous control of the endotracheal cuff pressure using a pneumatic device (n = 6). In the two groups, we inflated the endotracheal cuff with 50 ml air for 30 minutes, eight times daily. This hyperinflation of the endotracheal cuff aimed at mimicking high-pressure periods observed in intubated critically ill patients. In all animals, the cuff pressure and the airway pressure were continuously recorded for 48 hours. After sacrifice of the study animals, the trachea was removed and opened longitudinally for gross and histological examination. A pathologist evaluated the slides without knowledge of treatment group assignment. Results The cuff pressure was significantly lower in piglets with the pneumatic device than in piglets without the pneumatic device (median (interquartile range), 18.6 (11–19.4) cmH2O versus 26 (20–56) cmH2O, P = 0.009). No significant difference was found in the percentage of time spent with a cuff pressure <15 cmH2O and that with a cuff pressure between 30 and 50 cmH2O. The percentage of time between 15 and 30 cmH2O of cuff pressure, however, was significantly higher in piglets with the pneumatic device than in piglets without the pneumatic device (98% (95–99%) versus 65% (44–80%), P = 0.002). In addition, the percentage of time with cuff pressure >50 cmH2O was significantly lower in piglets with the pneumatic device than in piglets without the pneumatic device (0% versus 19% (12–41%), P = 0.002). In all animals, hyperemia and hemorrhages were observed at the cuff contact area. Histological examination showed no difference in tracheal lesions between animals with and without the pneumatic device. These lesions included deep mucous ulceration, squamous metaplasia and intense mucosal inflammation. No cartilage lesions were observed. Conclusion The pneumatic device provided effective continuous control of high-volume, low-pressure endotracheal cuff pressure in piglets mechanically ventilated for 48 hours. In the present model, however, no significant difference was found in tracheal mucosal lesions of animals with or without a pneumatic device. Further studies are needed to determine the impact of continuous control of cuff pressure over a longer duration of mechanical ventilation.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc6142.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc6142
Journal	Critical Care
Issue Number	5
Volume Number	11
Language	English
Publisher	BioMed Central
Publisher Date	2007-10-03
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Cuff Pressure Continuous Control Mucosal Blood Flow Tracheal Mucosa Endotracheal Tube Cuff
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Continuous control of endotracheal cuff pressure and tracheal wall damage: a randomized controlled animal study

Continuous control of tracheal cuff pressure and microaspiration of gastric contents: a randomized controlled study

wall damage: a randomized controlled animal study

Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia

A novel method to develop an elastic, thin-walled, leak-proof, inflatable tracheal tube cuff

Maintenance of tracheal tube cuff pressure: where are the limits?

Continuous control of tracheal cuff pressure: an effective measure to prevent ventilator-associated pneumonia?

The tracheal tube: gateway to ventilator-associated pneumonia

Cuff pressure control of the tracheal tube: a prospective study in a general ICU

Continuous control of endotracheal cuff pressure and tracheal wall damage: a randomized controlled animal study

Similar Documents

Continuous control of endotracheal cuff pressure and tracheal wall damage: a randomized controlled animal study

Continuous control of tracheal cuff pressure and microaspiration of gastric contents: a randomized controlled study

wall damage: a randomized controlled animal study

Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia

A novel method to develop an elastic, thin-walled, leak-proof, inflatable tracheal tube cuff

Maintenance of tracheal tube cuff pressure: where are the limits?

Continuous control of tracheal cuff pressure: an effective measure to prevent ventilator-associated pneumonia?

The tracheal tube: gateway to ventilator-associated pneumonia

Cuff pressure control of the tracheal tube: a prospective study in a general ICU

Continuous control of endotracheal cuff pressure and tracheal wall damage: a randomized controlled animal study