Impact of Tracheal Cuff Shape on Microaspiration in Intensive Care Units

Impact of Tracheal Cuff Shape on Microaspiration in Intensive Care Units

The investigators hypothesized that PVC tapered-cuff tracheal tubes would reduce microaspiration of gastric content as determined by pepsin level in tracheal aspirate.

Microaspiration is the main route for entry of contaminated secretions into the lower respiratory tract of intubated critically ill patients. Tracheobronchial colonization might progress to ventilator-associated pneumonia (VAP) when the quantity and virulence of bacteria are high and when local and general host defenses are weak.

Recent in vitro and animal studies suggest that tapered-cuff tracheal tubes could be associated with reduced microaspiration of contaminated secretions and might be helpful in preventing VAP.

Inclusion Criteria:

• age > or = 18 years
• tracheal intubation
• predictable duration of mechanical ventilation > 48h
• enteral nutrition

Exclusion Criteria:

• pregnant women
• refuse to participate to the study
• no informed consent
• contre indication for semirecumbent position