Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Maintenance of tracheal tube cuff pressure: where are the limits? | Available online http content 12 1 106 Commentary Maintenance of tracheal tube cuff pressure where are the limits Miquel Ferrer and Antoni Torres Unidad de Cuidados Intensivos e Intermedios Respiratorios Servei de Pneumologia Institut Clinic del Torax Hospital Clinic Institut d Investigacions Biomediques August Pi I Sunyer IDIBAPS CibeRes ISCiii-CB06 06 0028 Barcelona Spain Corresponding author Antoni Torres atorres@ Published 16 January 2008 This article is online at http content 12 1 106 2008 BioMed Central Ltd Critical Care 2008 12 106 doi cc6194 See related research by Nsier et al. http content 11 5 R109 Abstract Continuous control of tracheal tube cuff inflation using a pneumatic device resulted in severe tracheal wall damage in ventilated piglets. This damage was similar in piglets managed with manual control of cuff inflation. The periodic hyperinflation of the tube cuff used in both groups of this study may explain these results. This manoeuvre should be avoided in clinical practice. In a previous issue of Critical Care Nseir and colleagues presented an article regarding continuous control of endotracheal cuff pressure and tracheal wall damage 1 . Among the pathogenic mechanisms responsible for ventilator-associated pneumonia VAP oropharyngeal colonization by potentially pathogenic microorganisms and silent aspiration of subglottic secretions around the tracheal tube cuff seem to play a pivotal role 2 . In order to prevent pneumonia several approaches have been proposed - such as placing patients in the semirecumbent position 3 continuous aspiration of subglottic secretions CASS above the tracheal tube cuff 4 oropharyngeal decontamination by antiseptics 5 and the application of antiseptic-impregnated endotracheal tubes 6 . The key element of the proposed pathogenesis of VAP appears to be aspiration of colonized oropharyngeal and subglottic secretions. Appropriate control of the endotracheal tube cuff .
