IntelliCuff. Une solution intelligente de gestion de pression du ballonnet

Pour une pression de ballonnet contrôlée et une plus grande sécurité du patient

Une pression de ballonnet contrôlée et optimisée en continu facilite la thérapie de ventilation et protège vos patients contre la pneumonie acquise sous ventilateur (VAP) et les lésions de la trachée (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).

C'est l'IntelliCuff qui effectue la plus grande partie de ce travail pour vous. Il suffit de définir la pression du ballonnet souhaitée et l'IntelliCuff la maintient de façon automatique. Le dispositif peut fonctionner en toute sécurité dans une large plage de pressions de ballonnet avec plusieurs modèles de sondes d'intubation.

Que vous l'utilisiez en transport aérien avec des changements rapides de pression ambiante ou en salle d'opération pour des narcoses à l'azote ou lors de chirurgie, l'IntelliCuff surveille et maintient en continu une pression du ballonnet optimale pour une meilleure sécurité du patient. Même au cours de certaines des situations les plus critiques (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).

Avec vous où que vous soyez ! Compact et mobile dans toutes les situations

Adapté aux adultes, enfants et nouveau-nés. L'IntelliCuff sécurise la gestion des voies aériennes dans un grand nombre de situations : dans les unités de soins intensifs, les salles d'opération ou pendant un transport. Vous pouvez utiliser le dispositif pour un secours d'urgence sur terre ou dans les airs, même à des altitudes élevées.

Cliquez et restez. Une gamme de solutions de montage

Différentes interfaces vous permettent de monter l'IntelliCuff à l'endroit qui vous convient. Un simple clic suffit.

Une cohabitation parfaite avec son entourage. Compatibilité du ventilateur

Le dispositif autonome IntelliCuff est le compagnon idéal des ventilateurs Hamilton Medical.

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Collage de champs d'application de l'IntelliCuff

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Accessoires et consommables

Ligne de pression du ballonnet

Adaptateur USB pour automobile

Crochet

Système de montage Multi Mount

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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.

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