Impact of Monitoring Endotracheal Cuff Pressure on Endoscopic Laryngo-Tracheal Injury: A Randomized Pilot Study
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2017, Vol 24, Issue 9
Abstract
Aims: Underinflation (<20 cmH2O) and overinflation (>30 cmH2O) of tracheal cuff are independent factors of microaspiration and tracheal ischemic lesions respectively. The aim of this study was to evaluate the impact of discontinuous monitoring of endotracheal cuff pressure on the incidence of endoscopic laryngotracheal injury and to analyze factors associated with the development of these lesions. Study Design: Prospective and randomized study. Place and Duration of Study: Medical Intensive care unit at Taher Sfar Hospital in Mahdia, between December 2010 and April 2012. Methodology: All patients admitted to our intensive care unit (ICU) and requiring invasive mechanical ventilation for more than 48 hours were randomly assigned to have or not a discontinuous cuff pressure monitoring. The primary outcome was the incidence of endoscopic laryngotracheal injury during ICU stay. Secondary outcomes were the incidence of endoscopic laryngotracheal injury at day-90, ventilator-associated pneumonia, the length of stay, the duration of mechanical ventilation and mortality. Results: Ninety-five patients (49 in the monitored group and 46 in the control group) aged 59 ± 20 years, were included in the study. The incidence of endoscopic laryngotracheal injury was 42% with no significant difference between study groups. The proportion of patients with tracheal granulation was significantly lower in the monitored group: 4% vs 24% (p= 0.0049). Secondary outcomes were similar between the two groups. ICU admission for intoxication was the only independent factor associated with the occurrence of endoscopic laryngotracheal injury (OR 6.779, CI 95% (1.121- 41,008); p= 0.037). Conclusions: Discontinuous monitoring of cuff pressure did not reduce the overall incidence of endoscopic laryngotracheal injury but only the incidence of tracheal granuloma. These results recommend the routine survey of cuff pressure in ICU.
Authors and Affiliations
Tilouche Nejla, Ben Sik Ali Habiba, Jaoued Oussema, Gharbi Rim, Driss Nabil, Fekih Hassen Mohamed, Elatrous Souheil
Keywords
Related Articles
- EP ID EP312584
- DOI 10.9734/JAMMR/2017/37186
- Views 68
- Downloads 0
The Interactive Roles of Some Toxic Metals, Micronutrients, Antioxidant Vitamin and Sex Hormones in Nigerians with Sickle Cell Disease
Aims: To define the involvement of sex hormones-estradiol, testosterone, toxic metals and micronutrients in individuals with sickle cell disease (SCD). Study Design: A case control study. Place and Duration of Study: De...
Socio Demographic Determinants of Metabolic Syndrome and Its Components in South-West Nigeria
The occurrence of hypertension, obesity, dysglycaemia and dyslipidaemia together has been shown to result in increased risk of development of cardiovascular disease and diabetes. This present study assessed prevalence of...
Clinical and Radiographic Features of Knee Osteoarthritis of Elderly Patients
Background: Knee osteoarthritis is a common pathology, characterized by a prevalence that increases with age. Absence of correlation between anatomy and the clinical features makes medical care complex, particularly in a...
Dietary Intake Adequacy and Evaluation of Nutritional Value in Diabetic Patients
Aims: Diabetes as a health problem, leads to many pathological effects. Many studies showed that micronutrients found in these patients are not in accordance with the recommendations of RDA*. The aim of this study was to...
Comparison of Mantoux Reactivity in Smear Positive Pulmonary Tuberculosis Adults and Controls in Yenagoa, Nigeria
Background: Tuberculin skin tests (TST) are long established screening methods for tuberculosis (TB). We aimed to compare Mantoux test (a TST) in smear positive pulmonary tuberculosis adults and control subjects. From Ja...