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IntelliCuff。 聪明的气囊压力管理方式

IntelliCuff IntelliCuff
图:控制气囊压力

控制气囊压力和提高病人安全

持续性优化且受控的气囊压力支持通气治疗,让您的病人免受呼吸机相关性肺炎 (VAP) 和气管损伤的困扰 (Lorente L, Lecuona M, Jiménez A, et al.Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia.Crit Care.2014;18(2):R77.Published 2014 Apr 21. doi:10.1186/cc138371​)。

有了 IntelliCuff,将为您完成大部分这类工作。简单设置所需的气囊压力,然后 IntelliCuff 自动予以维持。针对各种带气囊的气管内插管,该设备可在大范围的安全压力范围内运行。

无论您将其用于环境气压快速变化的航空转运,还是在手术室用于 N2O 麻醉或手术,IntelliCuff 都可持续监测和维持最佳气囊压力和病人安全。即使在某些最紧急的情况下 (Nseir S, Zerimech F, Fournier C, et al.Continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients.Am J Respir Crit Care Med.2011;184(9):1041-1047. doi:10.1164/rccm.201104-0630OC2​)。

IntelliCuff IntelliCuff

陪伴您去任何地方! 紧凑、便携式设计,适用于任何情况

适用于成人、儿童和新生儿。IntelliCuff 在各种不同情况下安全管理气道——在 ICU、手术室或转运期间。您可以将其用于陆地或空中紧急抢救——即使在高海拔地区。

Sandra Rupp

客户评语

我们把 IntelliCuff 用作帮助预防机械通气病人发生呼吸机相关性肺炎的标准装置。IntelliCuff 定期自动调整气囊压力。这给了我们护理人员很大帮助,因为我们不再需要每小时手动检查气囊压力。

Sandra Rupp

ICU 护理部主任
瑞士库尔格劳宾登州州立医院

Hamilton Medical 哈美顿医疗公司呼吸机 Hamilton Medical 哈美顿医疗公司呼吸机

与呼吸机良好协作。 呼吸机兼容性

IntelliCuff 独立设备是 Hamilton Medical 哈美顿医疗公司呼吸机的完美伴侣

附件和耗材

Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia.

Lorente L, Lecuona M, Jiménez A, et al. Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia. Crit Care. 2014;18(2):R77. Published 2014 Apr 21. doi:10.1186/cc13837



INTRODUCTION

The use of a system for continuous control of endotracheal tube cuff pressure reduced the incidence of ventilator-associated pneumonia (VAP) in one randomized controlled trial (RCT) with 112 patients but not in another RCT with 142 patients. In several guidelines on the prevention of VAP, the use of a system for continuous or intermittent control of endotracheal cuff pressure is not reviewed. The objective of this study was to compare the incidence of VAP in a large sample of patients (n = 284) treated with either continuous or intermittent control of endotracheal tube cuff pressure.

METHODS

We performed a prospective observational study of patients undergoing mechanical ventilation during more than 48 hours in an intensive care unit (ICU) using either continuous or intermittent endotracheal tube cuff pressure control. Multivariate logistic regression analysis (MLRA) and Cox proportional hazard regression analysis were used to predict VAP. The magnitude of the effect was expressed as odds ratio (OR) or hazard ratio (HR), respectively, and 95% confidence interval (CI).

RESULTS

We found a lower incidence of VAP with the continuous (n = 150) than with the intermittent (n = 134) pressure control system (22.0% versus 11.2%; p = 0.02). MLRA showed that the continuous pressure control system (OR = 0.45; 95% CI = 0.22-0.89; p = 0.02) and the use of an endotracheal tube incorporating a lumen for subglottic secretion drainage (SSD) (OR = 0.39; 95% CI = 0.19-0.84; p = 0.02) were protective factors against VAP. Cox regression analysis showed that the continuous pressure control system (HR = 0.45; 95% CI = 0.24-0.84; p = 0.01) and the use of an endotracheal tube incorporating a lumen for SSD (HR = 0.29; 95% CI = 0.15-0.56; p < 0.001) were protective factors against VAP. However, the interaction between type of endotracheal cuff pressure control system (continuous or intermittent) and endotracheal tube (with or without SSD) was not statistically significant in MLRA (OR = 0.41; 95% CI = 0.07-2.37; p = 0.32) or in Cox analysis (HR = 0.35; 95% CI = 0.06-1.84; p = 0.21).

CONCLUSIONS

The use of a continuous endotracheal cuff pressure control system and/or an endotracheal tube with a lumen for SSD could help to prevent VAP in patients requiring more than 48 hours of mechanical ventilation.

Continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients.

Nseir S, Zerimech F, Fournier C, et al. Continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients. Am J Respir Crit Care Med. 2011;184(9):1041-1047. doi:10.1164/rccm.201104-0630OC



RATIONALE

Underinflation of the tracheal cuff frequently occurs in critically ill patients and represents a risk factor for microaspiration of contaminated oropharyngeal secretions and gastric contents that plays a major role in the pathogenesis of ventilator-associated pneumonia (VAP).

OBJECTIVES

To determine the impact of continuous control of tracheal cuff pressure (P(cuff)) on microaspiration of gastric contents.

METHODS

Prospective randomized controlled trial performed in a single medical intensive care unit. A total of 122 patients expected to receive mechanical ventilation for at least 48 hours through a tracheal tube were randomized to receive continuous control of P(cuff) using a pneumatic device (intervention group, n = 61) or routine care of P(cuff) (control group, n = 61).

MEASUREMENTS AND MAIN RESULTS

The primary outcome was microaspiration of gastric contents as defined by the presence of pepsin at a significant level in tracheal secretions collected during the 48 hours after randomization. Secondary outcomes included incidence of VAP, tracheobronchial bacterial concentration, and tracheal ischemic lesions. The pneumatic device was efficient in controlling P(cuff). Pepsin was measured in 1,205 tracheal aspirates. Percentage of patients with abundant microaspiration (18 vs. 46%; P = 0.002; OR [95% confidence interval], 0.25 [0.11-0.59]), bacterial concentration in tracheal aspirates (mean ± SD 1.6 ± 2.4 vs. 3.1 ± 3.7 log(10) cfu/ml, P = 0.014), and VAP rate (9.8 vs. 26.2%; P = 0.032; 0.30 [0.11-0.84]) were significantly lower in the intervention group compared with the control group. However, no significant difference was found in tracheal ischemia score between the two groups.

CONCLUSIONS

Continuous control of P(cuff) is associated with significantly decreased microaspiration of gastric contents in critically ill patients.