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Objective:

The aspiration of subglottic secretions colonized by bacteria pooled around the tracheal tube cuff due to inadvertent deflation (< 20 cm H 2 O) of the cuff plays a relevant role in the pathogenesis of ventilator-associated pneumonia. We assessed the efficacy of an automatic, validated device for the continuous regulation of tracheal tube cuff pressure in preventing ventilator-associated pneumonia.

Design:

Prospective randomized controlled trial.

Setting:

Respiratory intensive care unit and general medical intensive care unit.

Patients:

One hundred and forty-two mechanically ventilated patients (age, 64±17 yrs; Acute Physiology and Chronic Health Evaluation II score, 18±6) without pneumonia or aspiration at admission.

Interventions:

Within 24 hrs of intubation, patients were randomly allocated to undergo continuous regulation of the cuff pressure with the automatic device (n= 73) or routine care of the cuff …