Observational studyCritical care (London, England)2014
Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia.
Observational study in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 34 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of the Frequency of Ventilator-Associated Pneumonia in Intubated Patients Followed Up With Automatic Cuff Pressure Controller and Manual Cuff Pressure Controller in Pediatric Intensive Care; A Randomized Controlled Study
Automated Versus Manual Cuff Pressure Control for Preventing Microaspiration With TaperGuard Endotracheal Tubes in Elective Surgery: A Randomized Controlled Trial
Who cites it
34 citing papers in PubMed, 3 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- [Ventilator-associated pneumonia (VAP) : A risk already at the time of anesthetic induction].Der Anaesthesist · 2017Pooled it
- Subglottic secretion suction for preventing ventilator-associated pneumonia: an updated meta-analysis and trial sequential analysis.Critical care (London, England) · 2016Pooled it
- The value of polyurethane-cuffed endotracheal tubes to reduce microaspiration and intubation-related pneumonia: a systematic review of laboratory and clinical studies.Critical care (London, England) · 2016Pooled it
- Personalized automatic management of tracheal cuff pressure and subglottic secretions drainage to prevent pneumonia in critically ill intubated patients. The MICROINHALO multicenter randomized controlled trial.Intensive care medicine · 2026Trial
- Effectiveness of Continuous Endotracheal Cuff Pressure Control for the Prevention of Ventilator-Associated Respiratory Infections: An Open-Label Randomized, Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Silver-Coated Endotracheal Tubes Cleaned With a Mechanism for Secretion Removal.Respiratory care · 2019Trial
- Orotracheal tube as a risk factor for lower respiratory tract infection: preliminary data from a randomised trial.Wiener klinische Wochenschrift · 2018Trial
- Trial
- CO2 driven endotracheal tube cuff control in critically ill patients: A randomized controlled study.PloS one · 2017Trial
- Phantom system for endotracheal tube cuff seal testing during mechanical ventilation.Medical & biological engineering & computing · 2026Article
- Positional and Temporal Changes in Endotracheal Tube Cuff Pressure in Mechanically Ventilated Intensive Care Unit Patients: A Prospective Observational Study.Medical science monitor : international medical journal of experimental and clinical research · 2026Observational
- Arms-Based Meta-Analysis of Microbiological Endpoints of 88 VAP Prevention Studies Using Antimicrobial Versus Non-Antimicrobial Strategies-Towards 'VAP-Zero'?Antibiotics (Basel, Switzerland) · 2026Article
- Expert consensus-based clinical practice guidelines for Care and weaning procedures in tracheostomized ICU patients after invasive mechanical ventilation: a joint statement by the Intensive Care Physiotherapy Society (SKR) and the French Intensive Care Society (SRLF).Annals of intensive care · 2026Article
- Rapid Molecular Diagnostics for MDR Nosocomial Infections in ICUs: Integration with Prevention, Stewardship, and Novel Therapies.Diagnostics (Basel, Switzerland) · 2025Review
- Rebound Inverts theAntibiotics (Basel, Switzerland) · 2024Article
- Endotracheal Tube Cleaning Devices: A Means But Not a Solution.Respiratory care · 2023Article
- Pressure changes in the endotracheal tube cuff in otorhinolaryngologic surgery: a prospective observational study.Frontiers in medicine · 2023Article
- Intra-tracheal multiplexed sensing of contact pressure and perfusion.Biomedical optics express · 2022Article
- Effect of modified care bundle for prevention of ventilator-associated pneumonia in critically-ill neurosurgical patients.Acute and critical care · 2021Article
- Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients-A Retrospective and Prospective Cohort Study.Journal of clinical medicine · 2021Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe 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.
methodsWe 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).
resultsWe 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).
conclusionsThe 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.