IntelliCuff. La forma más inteligente de controlar la presión del manguito

Ilustración gráfica: presión del manguito controlada

Para una presión controlada del manguito y una mayor seguridad del paciente

La presión del manguito, que se controla y se optimiza constantemente, admite terapia ventilatoria y protege al paciente de sufrir neumonía asociada a la ventilación mecánica (NAV) y lesiones traqueales (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).

IntelliCuff hace casi todo el trabajo por usted. Basta con ajustar la presión de manguito que desee e IntelliCuff la mantendrá automáticamente. Este dispositivo puede utilizarse de forma segura con una amplia gama de presiones para diferentes tubos endotraqueales con manguito.

Independientemente de que se utilice durante el transporte aéreo con cambios bruscos en la presión ambiental, como en el quirófano para la anestesia general con N2O o la cirugía, IntelliCuff controla y mantiene continuamente una presión de manguito óptima para una mayor seguridad del paciente. Incluso durante algunas de las situaciones más críticas (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).

Le acompañará allá donde vaya. Compacto y portátil para cualquier situación

Adecuado para pacientes adultos, pediátricos y neonatos. IntelliCuff asegura el control de la vía aérea en una gran variedad de situaciones diferentes, desde las UCI y los quirófanos hasta en los traslados. Se puede utilizar para rescates de emergencia por tierra o aire, incluso a grandes altitudes.

Montaje con un solo clic. Toda una gama de soluciones de montaje

Sus diferentes interfaces le permiten montar el IntelliCuff donde lo necesite. Con un solo clic.

Se adapta con facilidad. Compatibilidad del respirador

El dispositivo independiente IntelliCuff es el compañero perfecto para los respiradores de Hamilton Medical.

Consulte todos nuestros respiradores

Montaje de ámbitos de uso del IntelliCuff

¡Siga aprendiendo! Descubra cómo utilizar el IntelliCuff

Accesorios y material fungible

Tubo de presión de manguito

Adaptador USB para vehículos

Gancho

Montaje múltiple

Catálogo electrónico

Más información

Documento

Notas al pie

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

Link to article

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

Link to article

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.

Hemos detectado que visita nuestro sitio web desde Estados Unidos.
Disponemos de una versión específica del sitio web para su país (Estados Unidos).

¿Hay algo que haya despertado su interés? Llámenos