Annals of Intensive Care volume 6 , pages 1โ Cite this article. Metrics details. Lille, Lille, France. Microaspiration of gastric and oropharyngeal contaminated secretions represents the primary mechanism involved in the pathogenesis of VAP. Tracheal cuff plays an important role in stopping the progression of contaminated secretions into the lower respiratory tract.
In vitro and animal studies suggested that leakage was significantly reduced with polyvinyl chloride PVC conical-cuffed tubes compared with barrel standard or cylindrical cuffs. Clinical studies found conflicting results. Therefore, the aim of this study is to determine the superiority of PVC conical- versus barrel standard -cuffed tracheal tube on abundant microaspiration of gastric contents in intubated critically ill patients.
After inclusion, tracheal aspirates were collected for 48 h to measure pepsin and salivary amylase, and diagnose gastric and oropharyngeal microaspiration. To diagnose tracheobronchial colonization, quantitative aspirate was performed after intubation and two times a week until extubation.
In patients with suspected VAP, quantitative tracheal aspirate or bronchoalveolar lavage was performed to confirm the diagnosis. Results A total of patients were included during the study period June โSeptember Pepsin and salivary amylase measurement is actually performed, and all results should be available in November Discussion Our study is sufficiently powered to detect a significant difference in microaspiration of gastric contents between patients intubated with conical-cuffed tracheal tubes and standard-cuffed tracheal tubes.
One of the strengths of this study is the use of quantitative measurement of pepsin as a marker of microaspiration. U de Caen, Caen, France. Introduction The administration of contrast media for imaging and interventional procedures is frequent in intensive care unit ICU. Whether volume expansion with bicarbonate is better than isotonic saline to reduce the risk of contrast-induced acute kidney injury CI-AKI in critically ill patients is unknown.
