Critical Illness
Conditions
Keywords
tracheal cuff pressure, continuous control, microaspiration
Brief summary
Despite intermittent control of tracheal cuff pressure using a manual manometer, cuff underinflations and overinflations frequently occur in critically ill patients, resulting in increased risk for microaspiration and tracheal ischemic lesions. The aim of this study is to determine the efficiency of Mallinckrodt electronic device (Mallinckrodt electronic cuff pressure controller, VBM Medizintechnik GmbH, Sulz aN) in continuous control of tracheal cuff pressure.
Interventions
continuous control of tracheal cuff pressure using an electronic device for 24 h followed by manual control of cuff pressure using a manometer
24 h of manual control using a manometer followed by 24 h of continuous control using an electronic device
Sponsors
Study design
Eligibility
Inclusion criteria
: * Patients intubated in the ICU with a high volume / low pressure PVC-cuffed tracheal tube * Predicted duration of mechanical ventilation \> or = 48h * Age \> or = 18 years * signed informed consent
Exclusion criteria
* Contraindication for semirecumbent position * Contraindication for enteral nutrition * Pregnancy * refuse to participate to the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| percentage of recording time spent with cuff overinflation or underinflation | 48 hours | Continuous recording of cuff pressure will be performed during 2 24-h periods (with or without Mallinckrodt device) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Impact of Mallinckrodt electronic device on microaspiration of gastric contents, documented by pepsin levels in tracheal aspirates | 48 hours | Pepsin will be quantitatively measured in tracheal aspirates of all patients during the 2 24-h periods (with or without Mallinckrodt device) |
Countries
France