Abstract
Introduction: An endotracheal tube enables patient ventilation, but also presents a risk of complications. The accumulation of subglottic secretions above the cuff may cause ventilatorassociated pneumonia. The purpose of the article is to establish the effect of the endotracheal tube cuff (shape and material, method of inflation, verifying and maintaining pressure) on the incidence of ventilator-associated pneumonia.
 Methods: A descriptive method with a systematic review of domestic and foreign literature was used. The literature was retrieved from electronic databases and the cooperative bibliographic/catalogue database. According to eligibility criteria, sixteen original scientific articles published in the last ten years were finally used. Data were processed with qualitative content analysis. 
 Results: Cuff inflation control with a manometer and continuous measuring and adjustment of cuff pressure with modern equipment were found to be the safest methods. According to the articles on shape and material, conical polyurethane cuffs provide the best sealing. 
 Discussion and conclusion: Ventilator-associated pneumonia is a serious complication in mechanically ventilated patients. Maintaining appropriate cuff pressure proved to be a very effective preventive measure. The research presented here is limited by the small number of available articles. Further research is needed before practical applications are attempted.
Highlights
An endotracheal tube enables patient ventilation, and presents a risk of complications
The purpose of the article is to establish the effect of the endotracheal tube cuff on the incidence of ventilator-associated pneumonia
Ventilator-associated pneumonia is a serious complication in mechanically ventilated patients
Summary
An endotracheal tube enables patient ventilation, and presents a risk of complications. An artificial airway with an inserted endotracheal tube (ETT) or tracheal cannula allows mechanical ventilation of the patient when it is not possible to provide appropriate ventilation with non-invasive methods or in the case of severe airway obstruction. It provides effective protection against the possible aspiration of stomach contents or oral and nasal secretions and allows easier removal of secretions from the lower respiratory tract. The artificial airway enables the rapid transition of pathogenic microorganisms into the lower respiratory tract due to a reduced defense mechanism and disabled cough reflex This increases the risk of ventilator-associated pneumonia (VAP) (Rosenblatt, 2006; St. John, 2006). Díaz and colleagues (2010) enumerate the factors that increase the risk of VAP in patients on MV: prone position, gastric distension, contamination of tubes or other parts of mechanical ventilator, frequent movement of patients and low cuff pressure
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