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Intensive Care Medicine
Erschienen in: Intensive Care Medicine 7/2010

01.07.2010 | Original

Impact of polyurethane on variations in tracheal cuff pressure in critically ill patients: a prospective observational study

verfasst von: Saad Nseir, Farid Zerimech, Julien De Jonckheere, Isabelle Alves, Malika Balduyck, Alain Durocher

Erschienen in: Intensive Care Medicine | Ausgabe 7/2010

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Abstract

Objective

To determine the impact of polyurethane (PU) on variations in cuff pressure (P cuff) in intubated critically ill patients.

Methods

Prospective observational before-after study performed in a ten-bed ICU. Cuff pressure was continuously recorded for 24 h in 76 intubated patients, including 26 with polyvinyl chloride (PVC), 22 with cylindrical polyurethane (CPU), and 28 with tapered polyurethane (TPU)-cuffed tracheal tubes. P cuff was manually adjusted every 8 h by nurses and was maintained around 25 cmH2O. Time spent with cuff underinflation and overinflation was continuously measured. In addition, pepsin, a proxy for microaspiration of gastric contents, was quantitatively measured in tracheal secretions at the end of recording period.

Results

A total of 1,824 h of continuous recording of cuff pressure was analyzed. Patient characteristics were similar in the three groups. No significant difference was found in percentage of time spent with underinflation (mean ± SD, 26 ± 22, 28 ± 12, 30 ± 13% in PVC, CPU, and TPU groups, respectively) and overinflation [median (IQR), 7 (2–14), 6 (3–14), 11% (5–20)] among the three groups. However, a significant difference was found in the coefficient of variation of P cuff (mean ± SD, 82 ± 48, 92 ± 47, 135 ± 67, p = 0.002). While the coefficient of P cuff variation was significantly (p < 0.017) higher in the TPU compared to CPU and PVC groups, no significant difference was found between the CPU and PVC groups. The pepsin level was significantly different among the three groups (408 ± 282, 217 ± 159, 178 ± 126 ng/ml; p < 0.001). In fact, the pepsin level was significantly lower in the CPU and TPU groups compared with the PVC group.

Conclusion

PU does not impact variations in P cuff in critically ill patients.
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Metadaten
Titel
Impact of polyurethane on variations in tracheal cuff pressure in critically ill patients: a prospective observational study
verfasst von
Saad Nseir
Farid Zerimech
Julien De Jonckheere
Isabelle Alves
Malika Balduyck
Alain Durocher
Publikationsdatum
01.07.2010
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 7/2010
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-010-1892-7

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