Reply: “Procedural Considerations on the Use of Polyurethane and/or Conical Cuffs”; “Estimating the Risk of Ventilator-associated Pneumonia as a Function of Time”; “Is Tracheobronchial Colonization a Good Marker for Microaspiration in Intubated Critically Ill Patients?”; and “TranslatingIn VitroResearch: Improving Endotracheal Tube Bench Test Methodology”

2015 ◽  
Vol 192 (5) ◽  
pp. 642-644
Author(s):  
François Philippart ◽  
Laurent Quinquis ◽  
Stéphane Gaudry ◽  
Islem Ouanes ◽  
Xavier Forceville ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Bench Test ◽  
Ventilator Associated Pneumonia ◽  
Good Marker ◽  
Test Methodology

scholarly journals Serum Procalcitonin Level and Mortality Risk in Critically ill Patients with Ventilator-Associated Pneumonia

2015 ◽  
Vol 37 (5) ◽  
pp. 1967-1972 ◽  
Author(s):  
Bo Li ◽  
Xin Zhao ◽  
Shumei Li
Keyword(s):  
Critically Ill ◽  
Mortality Risk ◽  
Critically Ill Patients ◽  
Cox Regression ◽  
High Serum ◽  
Ventilator Associated Pneumonia ◽  
Prognostic Role ◽  
Procalcitonin Level ◽  
Increased Risk

Background/Aims: The prognostic role of serum procalcitonin level in critically ill patients with ventilator-associated pneumonia was unclear. The aim of our study was to investigate the relationship between serum procalcitonin level and mortality risk in critically ill patients with ventilator-associated pneumonia. Methods: Data of critically ill patients with ventilator-associated pneumonia were retrospectively collected. Demographics, comorbidities, and serum procalcitonin level were extracted from electronic medical records. The primary outcome was mortality within two months after diagnosis. Multivariable Cox regression analyses were performed to assess the prognostic role of serum procalcitonin level in those patients. Results: A total of 115 critically ill patients with ventilator-associated pneumonia were enrolled in our study. Serum procalcitonin level was not associated with age, gender, or other comorbidities. Univariate Cox regression model showed that high serum procalcitonin level was associated increased risk of morality within 2 months after diagnosis (OR = 2.32, 95% CI 1.25-4.31, P = 0.008). Multivariable Cox regression model showed that high serum procalcitonin level was independently associated increased risk of morality within 2 months after diagnosis (OR = 2.38, 95% CI 1.26-4.50, P = 0.008). Conclusion: High serum procalcitonin level is an independent prognostic biomarker of mortality risk in critically ill patients with ventilator-associated pneumonia, and it's a promising biomarker of prognosis in critically ill patients.

scholarly journals Cardiopulmonary effects of bronchoalveolar lavage in critically ill patients with ventilator-associated pneumonia

Critical Care ◽  
10.1186/cc817 ◽  
2000 ◽  
Vol 4 (Suppl 1) ◽  
pp. P97
Author(s):  
A Koroneos ◽  
I Kalomenidis ◽  
F Moraitou ◽  
P Polakis ◽  
S Papanikolaou ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Ventilator Associated Pneumonia

scholarly journals Effect of routine vs on-demand nebulization of acetylcysteine with salbutamol on accumulation of airway secretions in endotracheal tubes: substudy of a randomized clinical trial

2020 ◽  
Vol 8 (S1) ◽  
Author(s):  
Sophia van der Hoeven ◽  
◽  
Lorenzo Ball ◽  
Federico Constantino ◽  
David M. van Meenen ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Work Of Breathing ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
Endotracheal Tubes ◽  
On Demand

Abstract Background Accumulated airway secretions in the endotracheal tube increase work of breathing and may favor airway colonization eventually leading to pneumonia. The aim of this preplanned substudy of the ‘Preventive Nebulization of Mucolytic Agents and Bronchodilating Drugs in Intubated and Ventilated Intensive Care Unit Patients trial’ (NEBULAE) was to compare the effect of routine vs on-demand nebulization of acetylcysteine with salbutamol on accumulation of secretions in endotracheal tubes in critically ill patients. Results In this single-center substudy of a national multicenter trial, patients were randomized to a strategy of routine nebulizations of acetylcysteine with salbutamol every 6 h until end of invasive ventilation, or to a strategy with on-demand nebulizations of acetylcysteine or salbutamol applied on strict clinical indications only. The primary endpoint, the maximum reduction in cross-sectional area (CSA) of the endotracheal tube was assessed with high-resolution computed tomography. Endotracheal tubes were collected from 72 patients, 36 from patients randomized to the routine nebulization strategy and 36 of patients randomized to the on-demand nebulization strategy. The maximum cross-sectional area (CSA) of the endotracheal tube was median 12 [6 to 15]% in tubes obtained from patients in the routine nebulization group, not different from median 9 [6 to 14]% in tubes obtained from patients in the on-demand nebulization group (P = 0.33). Conclusion In adult critically ill patients under invasive ventilation, routine nebulization of mucolytics and bronchodilators did not affect accumulation of airway secretions in the endotracheal tube. Trial registration Clinicaltrials.gov Identifier: NCT02159196

A multi-center evaluation of a disposable catheter to aid in correct positioning of the endotracheal tube after intubation in critically ill patients

2018 ◽  
Vol 48 ◽  
pp. 222-227
Author(s):  
Avi Cohen ◽  
Laren Tan ◽  
Ramiz Fargo ◽  
James D. Anholm ◽  
Chris Gasho ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Critically Ill ◽  
Critically Ill Patients

scholarly journals The effects of gastrointestinal function on the incidence of ventilator-associated pneumonia in critically ill patients

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 556-561
Author(s):  
Yuanqiang Lin ◽  
Zhixia Sun ◽  
Hui Wang ◽  
Meihan Liu
Keyword(s):  
Gastric Juice ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Ph Value ◽  
Serum Levels ◽  
Control Group ◽  
Gastrointestinal Function ◽  
Ventilator Associated Pneumonia ◽  
Observation Group ◽  
Gastric Feeding

AbstractObjectiveTo investigate the effect of gastrointestinal function on the incidence of ventilator-associated pneumonia (VAP) in critically ill patients.MethodsFrom August 2012 to June 2016, 160 critically ill patients in the ICU (Intensive Care Unit) of our hospital were selected as the research group; patients were divided equally into an observation group and a control group, 80 patients in each group, based on the random draw envelope principle. The control group was given a nasogastric tube for gastric feeding, the observation group was given a dual lumen gastrointestinal enteral device for gastric feeding; the two groups’ enteral nutrition observation time was 7d; any changes in patient condition and prognosis were recorded.ResultsThe pH value of gastric juice in the control group and the observation group was 6.13±1.38 and 4.01±1.83, respectively: the pH for the observation group was significantly lower than that of the control group (t=4.982, P<0.05). The incidence of VAP in the observation group and the control group was 2.5% and 12.5%, respectively: the VAP for the observation group was significantly lower than that of the control group (P<0.05). The serum levels of pre-albumin and albumin after feeding in the two groups were significantly higher than before feeding (P<0.05); the serum levels of pre-albumin and albumin in the observation group after feeding were significantly higher than those in the control group (P<0.05). The mechanical ventilation time and ICU length of stay in the observation group were 9.12±2.13 days and 12.76±1.98 days, respectively, significantly lower than those of the control group of 10.56±2.89 days and 16.33±2.11 days (P<0.05).ConclusionObstacles to gastrointestinal function in critically ill ICU patients are common; enteral gastric feeding by dual lumen gastrointestinal for can improve the patient’s nutritional status, promote and maintain the normal pH value of gastric juice, thereby reducing the incidence of VAP through rehabilitation of patients.

Effect of Probiotics on Incident Ventilator-Associated Pneumonia in Critically Ill Patients

JAMA ◽  
2021 ◽  
Vol 326 (11) ◽  
pp. 1024
Author(s):  
Jennie Johnstone ◽  
Maureen Meade ◽  
François Lauzier ◽  
John Marshall ◽  
Erick Duan ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Ventilator Associated Pneumonia

Oral measurement of temperature in orally intubated critical care patients: state-of-the-science review

2000 ◽  
Vol 9 (5) ◽  
pp. 334-343 ◽  
Author(s):  
WM Fallis
Keyword(s):  
Body Temperature ◽  
Endotracheal Tube ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nursing Time ◽  
Inappropriate Use ◽  
Use Of Resources ◽  
Oral Site ◽  
State Of The Science ◽  
Critical Care Patients

Many nurses are hesitant to use the oral site to measure body temperature when patients are orally intubated with an endotracheal tube. It is often thought that the temperature of the gases flowing through the tube and the patient's inability to form a tight seal around the tube may result in an inaccurate measurement that does not reflect body temperature. Consequently, other sites such as the rectum are used, resulting in embarrassment and increased stress for patients, increased use of resources, and inappropriate use of nursing time. An integrated review and synthesis of research on the validity of using the posterior sublingual site to measure temperature in critically ill patients intubated with an oral endotracheal tube were done to determine if a change in nursing practice is indicated for these patients. Of 10 studies that address this topic, 5 specifically investigated this nursing area. The results indicate that for critically ill patients with stable hemodynamic status, the posterior sublingual pocket is a valid site for measurement of body temperature in patients who are orally intubated with an endotracheal tube.

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