Cuff pressure control in the prevention of bronchoaspiration and development of ventilator-associated pneumonia during oral cavity manipulation: an integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i12.34926

Keywords:

Airway management; Pneumonia, Ventilator-associated; Dental staff, Hospital personal.

Abstract

Objective: To describe information on cuff pressure, used in intubated patients, as a preventive measure related to bronchoaspiration and the development of ventilator-associated pneumonia (VAP). Methodology: This is an integrative literature review, carried out in the SCOPUS® and MEDLINE® databases. The eligibility criteria used were studies published between 2010 and 2021, with full text available, such as retrospective, prospective, cohort, observational, pilot study, multicenter randomized study and systematic review. Duplicate studies and publications without the full text available were excluded from the selection process. Results: 11 studies met the eligibility criteria and were presented in a descriptive manner. It was found that the measurement of cuff pressure proved to be a safe way to manipulate the oral cavity and that continuous cuff control contributed to the prevention and reduction of complications such as bronchoaspiration and ventilator-associated pneumonia. In addition, control of cuff pressure with lumen for drainage of subglottic secretion may help prevent VAP in patients who require more than 48 hours of mechanical ventilation. Final considerations: care with cuff pressure of endotracheal tubes is of fundamental importance in reducing infections in critically ill patients, such as pneumonia associated with mechanical ventilation. In addition, monitoring cuff pressure, as a prophylactic method, becomes essential in the protocol routine of the multidisciplinary team of Intensive Care Units and can be performed by any trained member, including the dentist.

References

Alzahrani, A. R., Al Abbasi, S., Abahoussin, O. K. et al. (2015). Prevalence and predictors of out-of-range cuff pressure of endotracheal and tracheostomy tubes: a prospective cohort study in mechanically ventilated patients. BMC Anesthesiol, 15 (147), 1-7.

Baeder, F. M. et al. (2012). Condição odontológica em pacientes internados em unidade de terapia intensiva. Pesquisa Brasileira em Odontopediatria e Clínica Integrada, 12(4), 517-520.

Blum, D. F. C et al. (2018). A atuação da Odontologia em unidades de terapia intensiva no Brasil. Revista Brasileira de Terapia Intensiva, 30, 327-332.

Blum, D. F. C. et al. (2017). Influência da presença de profissionais em odontologia e protocolos para assistência à saúde bucal na equipe de enfermagem da unidade de terapia intensiva. Estudo de levantamento. Revista Brasileira de Terapia Intensiva, 29, 391-393.

Burja, S. et al. (2018). Efficacy of a bundle approach in preventing the incidence of ventilator associated pneumonia (VAP). Bosn J Basic Med Sci, 18(1), 105-109.

III Consenso Brasileiro de Ventilação Mecânica. Jornal Brasileiro de Pneumologia. <http://www.jornaldepneumologia.com.br>

Coppadoro, A. et al. (2019). Non-Pharmacological Interventions to Prevent Ventilator-Associated Pneumonia: A Literature Review. Respir Care, 64(12):1586-1595.

Dat, V. Q. et al. (2018). Continuous versus intermittent endotracheal cuff pressure control for the prevention of ventilator-associated respiratory infections in Vietnam: study protocol for a randomised controlled trial. Trials, 19 (217): 1-10.

Duarte, N. M. D. C. et al. (2020). Insuflação de balonete de tubo traqueal por método subjetivo: desempenho de médicos residentes e especialistas em anestesiologia. Estudo prospectivo observacional. Revista Brasileira de Anestesiologia, 70(1), 9-14.

Dexter, A. M., Scott, J. B. (2019). Airway Management and Ventilator-Associated Events. Respir Care, 64(8):986-993.

De Pascale, G. et al. (2017). CO2 driven endotracheal tube cuff control in critically ill patients: A randomized controlled study. PLoS One, 12(5), 1-15.

Lorente, L. et al. (2014). Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia. Crit Care, 18(2):1-8.

Mendes, K. D. S. et al. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto-enfermagem, 17(4), 758-64.

Marjanovic, N. et al. (2021). Continuous Pneumatic Regulation of Tracheal Cuff Pressure to Decrease Ventilator-associated Pneumonia in Trauma Patients Who Were Mechanically Ventilated: The AGATE Multicenter Randomized Controlled Study. Chest, 160(2), 499-508.

Penitenti, R. M. et al. (2010). Controle da pressão do cuff na unidade terapia intensiva: efeitos do treinamento. Rev Bras Ter Intensiva, 22(2), 192-195.

Pereira, D. M. C. et al. (2010). Abordagem fisioterapêutica no paciente com via aérea artificial. Profisio - Fisioterapia em terapia intensiva adulto, 2(2):125-170.

Rouzé, A. et al. (2018). Airway Devices in Ventilator-Associated Pneumonia Pathogenesis and Prevention. Clin Chest Med, 39(4):775-783.

Spapen, H. et al. (2020). An endotracheal tube providing "pressurized sealing" prevents fluid leakage in mechanically ventilated critically ill patients: a pilot study. J Anesth, 34(1), 144-148.

Tomaszek, L. et al. (2021). Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients-A Retrospective and Prospective Cohort Study. J Clin Med, 10(21), 1-12.

Wen, Z. et al. (2019). Is continuous better than intermittent control of tracheal cuff pressure? A meta-analysis. Nurs Crit Care, 24(2), 76-82.

Published

25/09/2022

How to Cite

BAEDER, F. M. .; ANDRADE, K. da S.; CORAZZA, P. F. L. .; MARTINI, K. de .; ALBUQUERQUE, A. C. L. de .; SILVA, D. F. .; MENONI, M. A. .; TEODÓSIO, G. C. .; ANDRADE, R. B. R. de M. .; CARDOSO, A. M. R. Cuff pressure control in the prevention of bronchoaspiration and development of ventilator-associated pneumonia during oral cavity manipulation: an integrative review. Research, Society and Development, [S. l.], v. 11, n. 12, p. e5281112334926, 2022. DOI: 10.33448/rsd-v11i12.34926. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/34926. Acesso em: 17 nov. 2024.

Issue

Section

Review Article