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Erschienen in: Intensive Care Medicine 11/2019

17.09.2019 | Less is more in Intensive Care

Endotracheal tube management during mechanical ventilation: less is more!

verfasst von: Robert M. Kacmarek, Gianluigi Li Bassi

Erschienen in: Intensive Care Medicine | Ausgabe 11/2019

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Excerpt

Care of the endotracheal tube (ETT) is frequently not the primary focus of ventilatory management of the critically ill, but it does have a major impact on the trajectory of recovery and complications that can extend long after the patient is extubated. Much of the approach to manage the airway is based on long-standing assumptions, not founded on evidence. As with all aspects of caring for the patient on mechanical ventilation (MV), evidenced-based medicine should be the rule. All aspects of airway care should be based on what is most appropriate for the patient. …
Literatur
1.
Zurück zum Zitat Young PJ, Rollinson M, Downward G, Henderson S (1997) Leakage of fluid past the tracheal tube cuff in a benchtop model. Br J Anaesth 78:557–562CrossRefPubMed Young PJ, Rollinson M, Downward G, Henderson S (1997) Leakage of fluid past the tracheal tube cuff in a benchtop model. Br J Anaesth 78:557–562CrossRefPubMed
5.
Zurück zum Zitat Girard TD, Alhazzani W, Kress JP et al (2016) An official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: liberation from mechanical ventilation in critically ill adults. Rehabilitation protocols, ventilator liberation protocols, and cuff leak tests. Am J Respir Crit Care Med 195:120–133. https://doi.org/10.1164/rccm.201610-2075ST CrossRef Girard TD, Alhazzani W, Kress JP et al (2016) An official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: liberation from mechanical ventilation in critically ill adults. Rehabilitation protocols, ventilator liberation protocols, and cuff leak tests. Am J Respir Crit Care Med 195:120–133. https://​doi.​org/​10.​1164/​rccm.​201610-2075ST CrossRef
7.
Zurück zum Zitat Klompas M, Branson R, Eichenwald EC et al (2014) Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 35(Suppl 2):S133–S154CrossRefPubMed Klompas M, Branson R, Eichenwald EC et al (2014) Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 35(Suppl 2):S133–S154CrossRefPubMed
9.
Zurück zum Zitat Branch-Elliman W, Wright SB, Howell MD (2015) Determining the ideal strategy for ventilator-associated pneumonia prevention. Cost-benefit analysis. Am J Respir Crit Care Med 192:57–63CrossRefPubMed Branch-Elliman W, Wright SB, Howell MD (2015) Determining the ideal strategy for ventilator-associated pneumonia prevention. Cost-benefit analysis. Am J Respir Crit Care Med 192:57–63CrossRefPubMed
10.
Zurück zum Zitat Lacherade JC, De Jonghe B, Guezennec P, Debbat K, Hayon J, Monsel A, Fangio P, Appere de Vecchi C, Ramaut C, Outin H, Bastuji-Garin S (2010) Intermittent subglottic secretion drainage and ventilator-associated pneumonia: a multicenter trial. Am J Respir Crit Care Med 182:910–917CrossRefPubMed Lacherade JC, De Jonghe B, Guezennec P, Debbat K, Hayon J, Monsel A, Fangio P, Appere de Vecchi C, Ramaut C, Outin H, Bastuji-Garin S (2010) Intermittent subglottic secretion drainage and ventilator-associated pneumonia: a multicenter trial. Am J Respir Crit Care Med 182:910–917CrossRefPubMed
13.
Zurück zum Zitat AARC (2010) AARC clinical practice guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010. Respir Care 55:758–764 AARC (2010) AARC clinical practice guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010. Respir Care 55:758–764
18.
Zurück zum Zitat Caruso P, Denari S, Ruiz SA, Demarzo SE, Deheinzelin D (2009) Saline instillation before tracheal suctioning decreased the incidence of ventilator-associated pneumonia. Crit Care Med 37:32–38CrossRefPubMed Caruso P, Denari S, Ruiz SA, Demarzo SE, Deheinzelin D (2009) Saline instillation before tracheal suctioning decreased the incidence of ventilator-associated pneumonia. Crit Care Med 37:32–38CrossRefPubMed
Metadaten
Titel
Endotracheal tube management during mechanical ventilation: less is more!
verfasst von
Robert M. Kacmarek
Gianluigi Li Bassi
Publikationsdatum
17.09.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 11/2019
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-019-05777-w

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