The Experts below are selected from a list of 6741 Experts worldwide ranked by ideXlab platform
Antoni Torres - One of the best experts on this subject based on the ideXlab platform.
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Maintenance of tracheal tube cuff pressure: where are the limits?
Critical Care, 2008Co-Authors: Miquel Ferrer, Antoni TorresAbstract:Continuous control of tracheal tube cuff inflation using a Pneumatic Device resulted in severe tracheal wall damage in ventilated piglets. This damage was similar in piglets managed with manual control of cuff inflation. The periodic hyperinflation of the tube cuff used in both groups of this study may explain these results. This manoeuvre should be avoided in clinical practice.
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Commentary Maintenance of tracheal tube cuff pressure: where are the limits?
2008Co-Authors: Miquel Ferrer, Antoni TorresAbstract:Continuous control of tracheal tube cuff inflation using a Pneumatic Device resulted in severe tracheal wall damage in ventilated piglets. This damage was similar in piglets managed with manual control of cuff inflation. The periodic hyperinflation of the tube cuff used in both groups of this study may explain these results. This manoeuvre should be avoided in clinical practice.
Saad Nseir - One of the best experts on this subject based on the ideXlab platform.
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Efficiency of a Pneumatic Device in controlling cuff pressure of polyurethane-cuffed tracheal tubes: a randomized controlled study.
BMC Anesthesiology, 2013Co-Authors: Emmanuelle Jaillette, Farid Zerimech, Julien De Jonckheere, Demosthenes Makris, Malika Balduyck, Alain Durocher, Alain Duhamel, Saad NseirAbstract:BACKGROUND: The primary objective of this study was to determine the efficiency of a Pneumatic Device in controlling cuff pressure (Pcuff) in patients intubated with polyurethane-cuffed tracheal tubes. Secondary objectives were to determine the impact of continuous control of Pcuff, and cuff shape on microaspiration of gastric contents. METHODS: Prospective randomized controlled study. All patients requiring intubation and mechanical ventilation >=48 h were eligible. The first 32 patients were intubated with tapered polyurethane-cuffed, and the 32 following patients were intubated with cylindrical polyurethane-cuffed tracheal tubes. Patients randomly received 24 h of continuous control of Pcuff using a Pneumatic Device (Nosten(R)), and 24 h of routine care of Pcuff using a manometer. Target Pcuff was 25 cmH2O. Pcuff was continuously recorded, and pepsin was quantitatively measured in all tracheal aspirates during these periods. RESULTS: The Pneumatic Device was efficient in controlling Pcuff (med [IQ] 26 [24, 28] vs 22 [20, 28] cmH2O, during continuous control of Pcuff and routine care, respectively; p = 0.017). In addition, percentage of patients with underinflation (31 % vs 68 %) or overinflation (53 % vs 100 %) of tracheal cuff, and percentage of time spent with underinflation (0.9 [0, 17] vs 14 % [4, 30]) or overinflation (0 [0, 2] vs 32 % [9, 54]) were significantly (p < 0.001) reduced during continuous control of Pcuff compared with routine care.No significant difference was found in microaspiration of gastric content between continuous control of Pcuff compared with routine care, or between patients intubated with tapered compared with cylindrical polyurethane-cuffed tracheal tubes. CONCLUSION: The Pneumatic Device was efficient in controlling Pcuff in critically ill patients intubated with polyurethane-cuffed tracheal tubes.The study was registered at clinicaltrial.gov (NCT01351259).
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Efficiency of a Pneumatic Device in controlling cuff pressure of polyurethane-cuffed tracheal tubes: a randomized controlled study
BMC anesthesiology, 2013Co-Authors: Emmanuelle Jaillette, Farid Zerimech, Julien De Jonckheere, Demosthenes Makris, Malika Balduyck, Alain Durocher, Alain Duhamel, Saad NseirAbstract:Background The primary objective of this study was to determine the efficiency of a Pneumatic Device in controlling cuff pressure (Pcuff) in patients intubated with polyurethane-cuffed tracheal tubes. Secondary objectives were to determine the impact of continuous control of Pcuff, and cuff shape on microaspiration of gastric contents.
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continuous control of tracheal cuff pressure for the prevention of ventilator associated pneumonia in critically ill patients where is the evidence
Current Opinion in Critical Care, 2013Co-Authors: Anahita Rouze, Saad NseirAbstract:Purpose of review Ventilator-associated pneumonia (VAP) is a major cause of death, morbidity and costs in ICUs. Several evidence-based clinical interventions have been increasingly described for its prevention. However, continuous control of tracheal cuff pressure (Pcuff) is rarely mentioned in the latest clinical guidelines. This review focuses on the available data about the management of Pcuff in the ICU, including discontinuous and continuous control, and its impact on the prevention of VAP. Recent findings Current discontinuous monitoring and adjustment of Pcuff, even well performed, is inaccurate in maintaining Pcuff in the target range. Underinflation (Pcuff <20cmH2O) of tracheal cuff is an independent risk factor for VAP through microaspiration of contaminated subglottic secretions into the lower respiratory tract. Two main types of Devices, electronic and Pneumatic, have been developed for the continuous control of Pcuff. Both have shown effectiveness in maintaining Pcuff in recommended range in ICU patients, but only the Pneumatic Device has provided a reduction in microaspiration and VAP incidence. Summary Continuous controllers of Pcuff represent effective, easy to use and timesaving Devices in today’s busy ICU environment. However, further studies are required to determine the impact of continuous control of Pcuff on VAP incidence, patient outcomes, antimicrobial consumption and to compare Pneumatic and electronic Devices, before generalizing their use in routine practice.
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continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients
American Journal of Respiratory and Critical Care Medicine, 2011Co-Authors: Saad Nseir, Farid Zerimech, Alain Durocher, P Ramon, Malika BalduyckAbstract:Rationale: Underinflation of the tracheal cuff frequently occurs in critically ill patients and represents a risk factor for microaspiration of contaminated oropharyngeal secretions and gastric contents that plays a major role in the pathogenesis of ventilator-associated pneumonia (VAP).Objectives: To determine the impact of continuous control of tracheal cuff pressure (Pcuff) on microaspiration of gastric contents.Methods: Prospective randomized controlled trial performed in a single medical intensive care unit. A total of 122 patients expected to receive mechanical ventilation for at least 48 hours through a tracheal tube were randomized to receive continuous control of Pcuff using a Pneumatic Device (intervention group, n = 61) or routine care of Pcuff (control group, n = 61).Measurements and Main Results: The primary outcome was microaspiration of gastric contents as defined by the presence of pepsin at a significant level in tracheal secretions collected during the 48 hours after randomization. Secon...
Miquel Ferrer - One of the best experts on this subject based on the ideXlab platform.
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Maintenance of tracheal tube cuff pressure: where are the limits?
Critical Care, 2008Co-Authors: Miquel Ferrer, Antoni TorresAbstract:Continuous control of tracheal tube cuff inflation using a Pneumatic Device resulted in severe tracheal wall damage in ventilated piglets. This damage was similar in piglets managed with manual control of cuff inflation. The periodic hyperinflation of the tube cuff used in both groups of this study may explain these results. This manoeuvre should be avoided in clinical practice.
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Commentary Maintenance of tracheal tube cuff pressure: where are the limits?
2008Co-Authors: Miquel Ferrer, Antoni TorresAbstract:Continuous control of tracheal tube cuff inflation using a Pneumatic Device resulted in severe tracheal wall damage in ventilated piglets. This damage was similar in piglets managed with manual control of cuff inflation. The periodic hyperinflation of the tube cuff used in both groups of this study may explain these results. This manoeuvre should be avoided in clinical practice.
Malika Balduyck - One of the best experts on this subject based on the ideXlab platform.
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Efficiency of a Pneumatic Device in controlling cuff pressure of polyurethane-cuffed tracheal tubes: a randomized controlled study.
BMC Anesthesiology, 2013Co-Authors: Emmanuelle Jaillette, Farid Zerimech, Julien De Jonckheere, Demosthenes Makris, Malika Balduyck, Alain Durocher, Alain Duhamel, Saad NseirAbstract:BACKGROUND: The primary objective of this study was to determine the efficiency of a Pneumatic Device in controlling cuff pressure (Pcuff) in patients intubated with polyurethane-cuffed tracheal tubes. Secondary objectives were to determine the impact of continuous control of Pcuff, and cuff shape on microaspiration of gastric contents. METHODS: Prospective randomized controlled study. All patients requiring intubation and mechanical ventilation >=48 h were eligible. The first 32 patients were intubated with tapered polyurethane-cuffed, and the 32 following patients were intubated with cylindrical polyurethane-cuffed tracheal tubes. Patients randomly received 24 h of continuous control of Pcuff using a Pneumatic Device (Nosten(R)), and 24 h of routine care of Pcuff using a manometer. Target Pcuff was 25 cmH2O. Pcuff was continuously recorded, and pepsin was quantitatively measured in all tracheal aspirates during these periods. RESULTS: The Pneumatic Device was efficient in controlling Pcuff (med [IQ] 26 [24, 28] vs 22 [20, 28] cmH2O, during continuous control of Pcuff and routine care, respectively; p = 0.017). In addition, percentage of patients with underinflation (31 % vs 68 %) or overinflation (53 % vs 100 %) of tracheal cuff, and percentage of time spent with underinflation (0.9 [0, 17] vs 14 % [4, 30]) or overinflation (0 [0, 2] vs 32 % [9, 54]) were significantly (p < 0.001) reduced during continuous control of Pcuff compared with routine care.No significant difference was found in microaspiration of gastric content between continuous control of Pcuff compared with routine care, or between patients intubated with tapered compared with cylindrical polyurethane-cuffed tracheal tubes. CONCLUSION: The Pneumatic Device was efficient in controlling Pcuff in critically ill patients intubated with polyurethane-cuffed tracheal tubes.The study was registered at clinicaltrial.gov (NCT01351259).
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Efficiency of a Pneumatic Device in controlling cuff pressure of polyurethane-cuffed tracheal tubes: a randomized controlled study
BMC anesthesiology, 2013Co-Authors: Emmanuelle Jaillette, Farid Zerimech, Julien De Jonckheere, Demosthenes Makris, Malika Balduyck, Alain Durocher, Alain Duhamel, Saad NseirAbstract:Background The primary objective of this study was to determine the efficiency of a Pneumatic Device in controlling cuff pressure (Pcuff) in patients intubated with polyurethane-cuffed tracheal tubes. Secondary objectives were to determine the impact of continuous control of Pcuff, and cuff shape on microaspiration of gastric contents.
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continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients
American Journal of Respiratory and Critical Care Medicine, 2011Co-Authors: Saad Nseir, Farid Zerimech, Alain Durocher, P Ramon, Malika BalduyckAbstract:Rationale: Underinflation of the tracheal cuff frequently occurs in critically ill patients and represents a risk factor for microaspiration of contaminated oropharyngeal secretions and gastric contents that plays a major role in the pathogenesis of ventilator-associated pneumonia (VAP).Objectives: To determine the impact of continuous control of tracheal cuff pressure (Pcuff) on microaspiration of gastric contents.Methods: Prospective randomized controlled trial performed in a single medical intensive care unit. A total of 122 patients expected to receive mechanical ventilation for at least 48 hours through a tracheal tube were randomized to receive continuous control of Pcuff using a Pneumatic Device (intervention group, n = 61) or routine care of Pcuff (control group, n = 61).Measurements and Main Results: The primary outcome was microaspiration of gastric contents as defined by the presence of pepsin at a significant level in tracheal secretions collected during the 48 hours after randomization. Secon...
Thomas Similowski - One of the best experts on this subject based on the ideXlab platform.
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control of tracheal cuff pressure a pilot study using a Pneumatic Device
Intensive Care Medicine, 2007Co-Authors: Alexandre Duguet, Leda Damico, Giuseppina Biondi, Helene Prodanovic, Jesus Gonzalezbermejo, Thomas SimilowskiAbstract:Objective To evaluate the efficacy of a simple mechanical Device to maintain constant endotracheal cuff pressure (Pcuff) during mechanical ventilation (large encased inflatable cuff connected to the endotracheal cuff and receiving constant pressure from a heavy mass attached to an articulated arm).