We hypothesized that continuous control of tracheal cuff pressure would reduce microaspiration of gastric content as determined by pepsin level in tracheal aspirate.
Randomized controlled open label study, performed in a 10-bed ICU. All patients intubated with a PVC-cuffed tracheal tube and receiving enteral nutrition who require at least 48 h of mechanical ventilation are eligible. Patients receive continuous control of cuff pressure using a pneumatic device (intervention group) or manual control using a manometer (control group). Target cuff pressure is 25 cmH2O. In all patients, pepsin is measured in tracheal aspirate during a 48-h period after inclusion, as proxy for gastric content aspiration. In addition tracheobronchial colonization and ventilator associated pneumonia rates will be compared between the two groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
122
Continuous control of cuff pressure using a pneumatic device (Nosten, Leved, France)
Manual control of cuff pressure is a routine practice in ICU patients
ICU, Calmette Hospital, University Hospital of Lille
Lille, Nord, France
Pepsin level in tracheal aspirate
Time frame: 48 h after randomization
Ventilator-associated pneumonia, tracheobronchial colonization, tracheal ischemic lesions
Time frame: day 28 after randomization
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