Purpose: The aim of this study was to determine whether the use of a polyurethane-cuffed endotracheal tube would result in a decrease in ventilator-associated pneumonia rate.
Materials And Methods: We replaced conventional endotracheal tube with a polyurethane-cuff endotracheal tube (Microcuff, Kimberly-Clark Corporation, Rosewell, Ga) in all adult mechanically ventilated patients throughout our large academic hospital from July 2007 to June 2008. We retrospectively compared the rates of ventilator-associated pneumonia before, during, and after the intervention year by interrupted time-series analysis.
Results: Ventilator-associated pneumonia rates decreased from 5.3 per 1000 ventilator days before the use of the polyurethane-cuffed endotracheal tube to 2.8 per 1000 ventilator days during the intervention year (P = .0138). During the first 3 months after return to conventional tubes, the rate of ventilator-associated pneumonia was 3.5/1000 ventilator days. Use of the polyurethane-cuffed endotracheal tube was associated with an incidence risk ratio of ventilator-associated pneumonia of 0.572 (95% confidence interval, 0.340-0.963). In statistical regression analysis controlling for other possible alterations in the hospital environment, as measured by rate of tracheostomy-ventilator-associated pneumonia, the incidence risk ratio of ventilator-associated pneumonia in patients intubated with polyurethane-cuffed endotracheal tube was 0.565 (P = .032; 95% confidence interval, 0.335-0.953).
Conclusions: Use of a polyurethane-cuffed endotracheal tube was associated with a significant decrease in the rate of ventilator-associated pneumonia in our study.
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http://dx.doi.org/10.1016/j.jcrc.2010.05.035 | DOI Listing |
Case Rep Dent
December 2024
Department of Maxillofacial Surgery, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Bergamo, Italy.
The authors present two cases of mouth floor hemorrhage consequences of implant placement within the atrophic anterior mandible. In one patient, the implant placement was associated with the guided bone regeneration (GBR) technique. This serious complication has been widely described in the literature, especially in the anterior mandible area.
View Article and Find Full Text PDFJ West Afr Coll Surg
August 2024
Department of Anaesthesia, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
Background: Considerable morbidity is attributable to inappropriate tracheal cuff pressure. An earlier study undertaken in our hospital revealed that a normal cuff pressure of 20-30 cm HO was achieved in only 6% of intubated patients using subjective estimation methods.
Objective: To determine whether a training intervention could improve the accuracy of the subjective estimation method in our tracheal cuff monitoring.
J Clin Anesth
December 2024
Department of Anesthesiology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing 100021, China. Electronic address:
Ann Otol Rhinol Laryngol
December 2024
Department of Otorhinolaryngology & Head-Neck Surgery, Medical College & Hospital, Kolkata; West Bengal, India.
Background: An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; ) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications.
Objectives: To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway.
Methods: In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window).
Cureus
November 2024
Microbiology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Background And Objectives: Stroke-associated pneumonia (SAP) is the aftermath of aspiration of oropharyngeal secretions or stomach content. Mechanical ventilation and lowered immunity and consciousness facilitate the etiopathogenesis of SAP. Antibiotic prophylaxis and repeated culture and sensitivity testing dampen the drug susceptibility patterns of the pathogens.
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