CHU Lille, Critical Care Center, bd du Pr Leclercq, Lille F-59000, France.
Department of Clinical Medicine, Trinity College, Welcome Trust-HRB Clinical Research Facility, St James Hospital, Dublin 94568, Ireland.
Clin Chest Med. 2018 Dec;39(4):775-783. doi: 10.1016/j.ccm.2018.08.001.
Airway devices play a major role in the pathogenesis of microaspiration of contaminated oropharyngeal and gastric secretions, tracheobronchial colonization, and ventilator-associated pneumonia (VAP) occurrence. Subglottic secretion drainage is an effective measure for VAP prevention, and no routine change of ventilator circuit. Continuous control of cuff pressure, silver-coated tracheal tubes, low-volume low-pressure tracheal tubes, and the mucus shaver are promising devices that should be further evaluated by large randomized controlled trials. Polyurethane-cuffed, conical-shaped cuff, and closed tracheal suctioning system are not effective and should not be used for VAP prevention.
气道装置在污染的口咽和胃分泌物的微吸入、气管支气管定植和呼吸机相关性肺炎（VAP）发生的发病机制中起主要作用。声门下分泌物引流是预防 VAP 的有效措施，无需常规更换呼吸机回路。持续控制气囊压力、涂银气管导管、小容量低压气管导管和黏液清除器是有前途的装置，应通过大型随机对照试验进一步评估。聚氨酯套囊、圆锥形套囊和密闭式气管吸引系统无效，不应用于预防 VAP。
