Department of Anesthesiology and Reanimation, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey.
Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa, Institute of Cardiology, Istanbul, Turkey.
J Invest Surg. 2022 Mar;35(3):525-530. doi: 10.1080/08941939.2021.1881190. Epub 2021 Feb 14.
Ventilator-associated pneumonia (VAP) is a common cause of morbidity and mortality in intensive care unit (ICU), and among the several preventative strategies described to reduce the incidence of VAP, the most important is the endotracheal tube cuff (ETC) pressure. The present study was conducted on 60 patients who required mechanical ventilation (MV) in the ICU with traumatic brain injury (TBI).
The patients were randomized into two groups of 30, in which ETC pressure was regulated using a smart cuff manager (SCM) (Group II), or manual measurement approach (MMA) (Group I). Demographic data, MV duration, length of ICU stay and mortality rates were recorded. The clinical pulmonary infection scores (CPISs), C-reactive protein (CRP) values, and the fraction of inspired oxygen (FiO2) and positive end-expiratory pressure (PEEP) values of the groups were compared at baseline, and at hours 48, 72 and 96.
In Group I, CPIS values significantly higher than Group II in 48th, 72nd and 96th hours ( < 0.05). In Group I, PEEP values and deep tracheal aspirate (DTA) culture growth rates significantly higher than Group II in 72nd and 96th hours ( < 0.05).
The continuous maintenance of ETC pressure using SCM reduced the incidence of VAP.
呼吸机相关性肺炎（VAP）是重症监护病房（ICU）发病率和死亡率的常见原因，在预防 VAP 的几种策略中，最重要的是气管内导管套囊（ETC）压力。本研究对 60 例因创伤性脑损伤（TBI）需要机械通气（MV）的 ICU 患者进行了研究。
将患者随机分为两组，每组 30 例，分别使用智能套囊管理器（SCM）（II 组）或手动测量方法（MMA）（I 组）调节 ETC 压力。记录患者的人口统计学数据、MV 持续时间、ICU 住院时间和死亡率。比较两组患者在基线时、48 小时、72 小时和 96 小时的临床肺部感染评分（CPIS）、C 反应蛋白（CRP）值以及吸入氧分数（FiO2）和呼气末正压（PEEP）值。
I 组患者在第 48、72 和 96 小时的 CPIS 值明显高于 II 组（<0.05）。在第 72 和 96 小时，I 组患者的 PEEP 值和深吸痰（DTA）培养增长率明显高于 II 组（<0.05）。
使用 SCM 持续维持 ETC 压力可降低 VAP 的发生率。
