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Control of tracheal cuff pressure: a pilot study using a pneumatic device

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Abstract

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).

Design and setting

Single-center, prospective, randomized, crossover, pilot study in a medical intensive care unit.

Patients and participants

Nine consecutive mechanically ventilated patients (age 62 ± 20 years, SAPS II score 39 ± 15).

Interventions

Control day: Pcuff monitored and adjusted with a manometer (Hi-Lo™, Tyco Healthcare) according to current recommendations (twice a day and after each intervention on the tracheal tube); initial target Pcuff 22–28 cmH20. Prototype day: test device connected to the endotracheal cuff; same initial target. Continuous Pcuff recording during both days. Control and prototype days in random order.

Results

Pcuff values over 50 cmH20 were recorded in six patients during the control day (178 ± 159 min), never during the prototype day. During the control day, Pcuff was between 30 and 50 cmH20 for 29 ± 25% of the time, vs 0.3 ± 0.3% during the prototype day (p < 0.01). Pcuff was between 15 and 30 cmH20 for 56 ± 36% of the time during the control day, vs 95 ± 14% during the prototype day (p < 0.01). During the control day, Pcuff was below 15 cmH20 for 15 ± 17% of the time, vs 4.7 ± 15% during the prototype day (p < 0.05).

Conclusions

The tested device successfully controlled Pcuff with minimal human resource consumption. Prospective studies are required to assess its clinical impact.

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Acknowledgements

The authors gratefully thank the intensive care unit nursing staff for their unfailing cooperation and patience. They thank Mr. Edouard Leveque, inventor of the Nosten® device, for his help, and Pr. Jean-Philippe Derenne and Nunzio Crimi for their precious input. They also thank Mrs. Marilyn Amouyal-Jones for her help with English style and grammar. Funding: Association pour le Développement et l'Organisation de la Recherche en Pneumologie (ADOREP), Paris, France.

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Authors and Affiliations

  1. Unité de Réanimation, Service de Pneumologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83, Bd de l’Hôpital, 75651, Paris Cedex 13, France

    Alexandre Duguet, Leda D’Amico, Giuseppina Biondi, Hélène Prodanovic, Jésus Gonzalez-Bermejo & Thomas Similowski

  2. Unité Propre de Recherche de l’Enseignement Supérieur EA 2397, Université Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Paris, France

    Alexandre Duguet, Jésus Gonzalez-Bermejo & Thomas Similowski

  3. Servizio Allergologia, Istituto Maladie Respiratorie, Ospedale Ascoli Tomaselli e Universita degli Studi di Catania, Catania, Italy

    Leda D’Amico & Giuseppina Biondi

Authors
  1. Alexandre Duguet
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  2. Leda D’Amico
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  3. Giuseppina Biondi
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  4. Hélène Prodanovic
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  5. Jésus Gonzalez-Bermejo
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  6. Thomas Similowski
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Corresponding author

Correspondence to Alexandre Duguet.

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Duguet, A., D’Amico, L., Biondi, G. et al. Control of tracheal cuff pressure: a pilot study using a pneumatic device. Intensive Care Med 33, 128–132 (2007). https://doi.org/10.1007/s00134-006-0417-x

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  • DOI: https://doi.org/10.1007/s00134-006-0417-x

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