Ventilator‐associated pneumoniaDiagnosis, pathogenesis and prevention

Young, Peter; Ridley, S.

doi:10.1046/j.1365-2044.1999.01035.x

Cited by 40 publications

(26 citation statements)

References 93 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, we considered 60 to 70 cmH 2 O for LMA and 20-30 cmH 2 O for ETT cuffs to be normal. As soon as an airway was established, cuff pressures were measured and recorded in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Cuffs inflated to an inappropriately high pressure cause ischemia by reducing tracheal mucosal blood flow, while cuffs inflated at pressures lower than necessary give rise to inadequate ventilation or aspiration of gastric contents (1). In critically ill patients, contaminated secretions can leak through the tracheal cuff and result in ventilator-associated pneumonia (2,3). High cuff pressure increases the risk for tracheomalacia and tracheal dilation in patients intubated for a long time (4).…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Professional Experience of Anaesthesiologists in Proper Inflation of Laryngeal Mask and Endotracheal Tube Cuff

Saraçoğlu¹,

Dal²,

Pehlivan³

et al. 2014

Turk J Anesth Reanim

View full text Add to dashboard Cite

Objective: Cuffs inflated to inappropriately high pressures cause ischemia, reducing tracheal mucosal blood flow, while cuffs inflated at lower pressure than necessary give rise to inadequate ventilation, aspiration of gastric contents, or extubation due to air leakage. In this study, we aimed to investigate the effect of the experience of anaesthesia staff on endotracheal tube and laryngeal mask airway cuff inflation. Methods:The study included 348 elective patients scheduled to undergo surgery under general anaesthesia, with 34 anaesthesia technicians, 16 anaesthesia residents, and 12 anaesthesiologists with different years of professional experience. The participants were told to inflate the cuff balloon with air to the level of the pressure that was appropriate for them. No information was provided to the participants about the values of the cuff pressure pending the completion of all measurements. After placement of the laryngeal mask airway and endotracheal tube, the success of the procedure was checked by monitoring square-wave capnograph tracing and thoracoabdominal motion. Each participant performed the procedures on three patients, and the mean cuff pressures were measured. Results:There was no significant correlation between duration of experience of technicians, residents, and experts in using laryngeal mask airway pressure (r=-0.192/p=0.278, r=0.225/p=0.402, r=-0.476/p=0.118, respectively) and endotracheal tube (r=-0.306/ p=0.079, r=-0.060/p=0.826, r=-0.478/0.116, respectively). Conclusion:It has been concluded that professional experience does not contribute to achieving normal cuff pressure without monitoring. Introduction of the cuff manometer into routine anaesthesia practice will be useful, irrespective of anaesthesiologists' experience.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Professional Experience of Anaesthesiologists in Proper Inflation of Laryngeal Mask and Endotracheal Tube Cuff

Saraçoğlu¹,

Dal²,

Pehlivan³

et al. 2014

Turk J Anesth Reanim

View full text Add to dashboard Cite

show abstract

“…12 Though enteral feed via nasogastric tube has been stated as a risk factor due to increased gastric pH, volume and regurgitation, it may have improved the nutritional status, decreased gut translocation and prevented VAP in our patients. 14,15 Intermittent feed, semi-recombinant position at 45°, avoidance of gastric over distension and use of prokinetics when required, has decreased the incidence of VAP in some studies. 16,17 Similar finding was observed in our study.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Ventilator-Associated Pneumonia in Kathmandu University Hospital

Shrestha

Bhattarai

2012

Kathmandu Univ. Med. J.

View full text Add to dashboard Cite

show abstract

“…• Gastrostasis, reflux and aspiration are promoted by a static supine position.Ventilator-associated pneumonia, and prolonged ventilation and intensive care stay are consequences [54], increasing morbidity, mortality and costs [55,56]. Among elderly patients with cervical spine injuries, 26.8% died during treatment, principally as a result of respiratory complications [57].…”

mentioning

confidence: 99%

Clearing the cervical spine in unconscious polytrauma victims, balancing risks and effective screening

Morris¹,

McCoy²

2004

Anaesthesia

106

View full text Add to dashboard Cite

SummaryCervical spine injury occurs in 5-10% of cases of blunt polytrauma. A missed or delayed diagnosis of cervical spine injury may be associated with permanent neurological sequelae. However, there is no consensus about the ideal evaluation and management of the potentially injured cervical spine and, despite the publication of numerous clinical guidelines, this issue remains controversial. In addition, many studies are limited in their application to the obtunded or unconscious trauma victim. This review will provide the clinician managing unconscious trauma victims with an assessment of the actual performance of clinical examination and imaging modalities in detecting cervical spine and isolated ligamentous injury, a review of existing guidelines in light of the available evidence, relative risk estimates and a proposed management scheme. Cervical spine and associated spinal cord injury significantly affect the individual's functional capacity and quality of life, and carry significant implications for society. It was estimated in 1988 that a 27-year-old rendered tetraparetic would consume US$ 1 million for lifetime care and, with 721 tetraparetic individuals per million of the population, the total aggregate costs were an estimated US$ 5.6 billion per year [1]. In America, cervical, thoracic and lumbar vertebral fractures occur with an incidence of 50 000 per year [2], and cervical spine injury has an annual incidence of 5-10 000 cases per year [3,4]. More recent estimates suggest an incidence of 8-10 000 spinal cord injuries per year, of which 55% are cervical [5]. In the UK, there are approximately 1000 new cases of cervical cord injury each year [6]. Cervical spine injury complicates blunt polytrauma in 2-12% of cases [7][8][9]. However, several larger reviews that include 29 000 blunt trauma victims, and additional prospectively gathered data, demonstrate a generally lower incidence (2.0-5.2%) [10][11][12][13].The presence of a severe head injury increases the relative risk of a cervical spine injury, possibly by 8.5 times, and a focal neurological deficit by 58 times [14]. A Glasgow Coma Scale (GCS) score of < 8 is associated with a 50% increase in the incidence of cervical spine injury to 7.8% [15]. Similarly, Demetriades et al.[16] have shown that although the incidence of cervical spine injury in trauma victims with a GCS score of 13-15 was only 1.4%; this increased to 10.2% if GCS was < 8. 'Primary' cervical spine injury may be associated with head injury in 24-35% of cases [10,[16][17][18][19][20], and among polytrauma victims requiring cervical spine stabilization surgery, only 74% suffered an isolated injury [21]. The prognosis in patients suffering both head and cervical injury is typically poor, with approximately 25% being discharged to a dedicated nursing facility with little prospect of recovery [22]. Traumatic brain injury has a UK incidence of 100 per 100 000 population [23], typically among young, working age males, and therefore the combined consequences of brain and spine injury both ...

show abstract

Ventilator‐associated pneumoniaDiagnosis, pathogenesis and prevention

Cited by 40 publications

References 93 publications

The Professional Experience of Anaesthesiologists in Proper Inflation of Laryngeal Mask and Endotracheal Tube Cuff

The Professional Experience of Anaesthesiologists in Proper Inflation of Laryngeal Mask and Endotracheal Tube Cuff

Incidence and Risk Factors for Ventilator-Associated Pneumonia in Kathmandu University Hospital

Clearing the cervical spine in unconscious polytrauma victims, balancing risks and effective screening

Contact Info

Product

Resources

About