Use of an innovative cuff pressure control and subglottic secretions drainage system in COVID-19 ARDS patients undergoing pronation.
Acute respiratory distress syndrome
Continuous cuff pressure control
Microaspiration
Subglottic secretion drainage
Ventilator-associated pneumonia
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
04 11 2022
04 11 2022
Historique:
received:
17
07
2022
accepted:
28
10
2022
entrez:
4
11
2022
pubmed:
5
11
2022
medline:
8
11
2022
Statut:
epublish
Résumé
We conducted a proof of concept study where Anapnoguard endotracheal tubes and its control unit were used in 15 patients with COVID-19 acute respiratory distress syndrome. Anapnoguard system provides suction, venting, rinsing of subglottic space and controls cuff pressure detecting air leakage through the cuff. Alpha-amylase and pepsin levels, as oropharyngeal and gastric microaspiration markers, were assessed from 85 tracheal aspirates in the first 72 h after connection to the system. Oropharyngeal microaspiration occurred in 47 cases (55%). Episodes of gastric microaspiration were not detected. Patient positioning, either prone or supine, did not affect alpha-amylase and pepsin concentration in tracheal secretions. Ventilator-associated pneumonia (VAP) rate was 40%. The use of the AG system provided effective cuff pressure control and subglottic secretions drainage. Despite this, no reduction in the incidence of VAP has been demonstrated, compared to data reported in the current COVID-19 literature. The value of this new technology is worth of being evaluated for the prevention of ventilator-associated respiratory tract infections.
Identifiants
pubmed: 36329540
doi: 10.1186/s13054-022-04225-4
pii: 10.1186/s13054-022-04225-4
pmc: PMC9635168
doi:
Substances chimiques
Pepsin A
EC 3.4.23.1
alpha-Amylases
EC 3.2.1.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
338Informations de copyright
© 2022. The Author(s).
Références
Crit Care Med. 2022 Oct 1;50(10):1430-1439
pubmed: 35880890
Am J Respir Crit Care Med. 2007 Dec 1;176(11):1079-83
pubmed: 17872488
Chest. 2021 Aug;160(2):454-465
pubmed: 33857475
PLoS One. 2014 Mar 06;9(6):e90851
pubmed: 24603906
Intensive Care Med. 2021 Feb;47(2):188-198
pubmed: 33388794
PLoS One. 2017 May 11;12(5):e0175476
pubmed: 28493877
Anesth Analg. 2005 Oct;101(4):1081-1088
pubmed: 16192525
BMC Infect Dis. 2014 Nov 28;14:119
pubmed: 25430629
Ann Transl Med. 2018 Nov;6(21):428
pubmed: 30581836
Intensive Crit Care Nurs. 2021 Apr;63:103010
pubmed: 33461862