The investigators hypothesized that PVC tapered-cuff tracheal tubes would reduce microaspiration of gastric content as determined by pepsin level in tracheal aspirate.
Microaspiration is the main route for entry of contaminated secretions into the lower respiratory tract of intubated critically ill patients. Tracheobronchial colonization might progress to ventilator-associated pneumonia (VAP) when the quantity and virulence of bacteria are high and when local and general host defenses are weak. Recent in vitro and animal studies suggest that tapered-cuff tracheal tubes could be associated with reduced microaspiration of contaminated secretions and might be helpful in preventing VAP.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
326
Patients will be intubated with tapered-shape tracheal tubes
Patients will be intubated with standard PVC cuffed tracheal tubes
ICU, Salengro Hospital, University Hospital of Lille
Lille, Nord, France
centre Hospitalier
Boulogne-sur-Mer, France
Centre Hospitalier
Dunkirk, France
Centre Hospitalier
Lens, France
Microaspiration of gastric contents
Mesuerment of pepsin level in tracheal aspirate will be used to quantify microaspiration of gastric contents
Time frame: 48 hours after randomization
Microaspiration of oropharyngeal secretions
amylase level on tracheal aspirate would allow to quantify microaspiration of oropharyngeal secretions
Time frame: 48 h after randomization
Tracheobronchial colonization
Time frame: 28 days after randomization
Ventilator-associated pneumonia
Time frame: 28 days after randomization
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Centre Hospitalier St Philibert
Lomme, France
Centre hospitalier
Roubaix, France
Centre Hospitalier Universitaire
Rouen, France
Centre Hospitalie
Tourcoing, France
Centre Hospitalier
Valenciennes, France