Abstract
In a previous issue of Critical Care, Lorente and colleagues reported the results of a prospective observational study aiming at evaluating the effect of continuous control of cuff pressure (Pcuff ) on the incidence of ventilator-associated pneumonia (VAP). The results suggest a beneficial impact of this intervention on VAP prevention, which is in line with the results of a recent randomized controlled study. However, another randomized controlled study found no significant impact of continuous control of Pcuff on VAP incidence. Several differences regarding the device used to control Pcuff, study population, and design might explain the different reported results. Future randomized multicenter studies are needed to confirm the beneficial effect of continuous control of Pcuff on VAP incidence. Furthermore, the efficiency and cost-effectiveness of different available devices should be compared. Meanwhile, given the single-center design and the limitations of the available studies, no strong recommendation can be made regarding continuous control of Pcuff as a preventive measure of VAP.
Highlights
In a previous issue of Critical Care, Lorente and colleagues [1] reported the results of a prospective study aiming at evaluating the impact of continuous control of cuff pressure (Pcuff ) on the incidence of ventilatorassociated pneumonia (VAP)
Whereas the main clinical characteristics were similar in the study groups, VAP rate was significantly reduced by the use of continuous control of Cuff pressure (Pcuff)
The lower rate of VAP in patients who received continuous control of Pcuff is in line with the results of a recent randomized controlled study performed by our group [4], the primary outcome of that study was not VAP but abundant microaspiration of gastric content
Summary
In a previous issue of Critical Care, Lorente and colleagues [1] reported the results of a prospective study aiming at evaluating the impact of continuous control of cuff pressure (Pcuff ) on the incidence of ventilatorassociated pneumonia (VAP) They included a large number of patients intubated and ventilated for more than 48 hours (150 patients in a continuous control group and 134 patients in a routine care group). The lower rate of VAP in patients who received continuous control of Pcuff is in line with the results of a recent randomized controlled study performed by our group [4], the primary outcome of that study was not VAP but abundant microaspiration of gastric content. Cedex, France 2EA 2694, Université Nord de France, 1 Place de Verdum, 59000 Lille, France
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