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IntelliCuff. The clever way to manage cuff pressure

IntelliCuff IntelliCuff
Graphical illustration: controlled cuff pressure

For controlled cuff pressure and greater patient safety

Continuously optimized and controlled cuff pressure supports ventilation therapy and protects your patients from ventilator associated pneumonia (VAP) and tracheal injuries (Lorente L, Lecuona M, Jiménez A, et al. Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia. Crit Care. 2014;18(2):R77. Published 2014 Apr 21. doi:10.1186/cc138371​).

With IntelliCuff, most of this work is done for you. Simply set the desired cuff pressure and IntelliCuff maintains it automatically. The device can operate within a wide, but safe range of pressures for various cuffed endotracheal tubes.

Whether you use it for air transport with quickly changing ambient pressure or in the operating room during N2O narcosis or surgery, IntelliCuff continuously monitors and maintains optimal cuff pressure for greater patient safety. Even during some of the most critical situations (Nseir S, Zerimech F, Fournier C, et al. Continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients. Am J Respir Crit Care Med. 2011;184(9):1041-1047. doi:10.1164/rccm.201104-0630OC2​).

IntelliCuff IntelliCuff

With you wherever you go! Compact and portable for any situation

Suitable for adults, pediatrics and neonates. IntelliCuff secures airway management in a range of different situations ‑ in the ICU and the operating room, or during transport. You can use it for emergency rescue on land or in the air ‑ even at higher altitudes.

Sandra Rupp

Customer voices

We use IntelliCuff as a standard feature to help prevent VAP in mechanically ventilated patients. IntelliCuff controls the cuff pressure automatically and regularly. This is a great help for us caregivers since we don’t have to check the cuff pressure manually every hour.

Sandra Rupp

Head of ICU Nursing Department
Grisons Cantonal Hospital, Chur, Switzerland

Hamilton Medical ventilators Hamilton Medical ventilators

Plays nicely with friends. Ventilator compatibility

The IntelliCuff standalone device is the perfect companion for Hamilton Medical ventilators.

Accessories and consumables

Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia.

Lorente L, Lecuona M, Jiménez A, et al. Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia. Crit Care. 2014;18(2):R77. Published 2014 Apr 21. doi:10.1186/cc13837



INTRODUCTION

The 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.

METHODS

We 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).

RESULTS

We 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).

CONCLUSIONS

The 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.

Continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients.

Nseir S, Zerimech F, Fournier C, et al. Continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients. Am J Respir Crit Care Med. 2011;184(9):1041-1047. doi:10.1164/rccm.201104-0630OC



RATIONALE

Underinflation of the tracheal cuff frequently occurs in critically ill patients and represents a risk factor for microaspiration of contaminated oropharyngeal secretions and gastric contents that plays a major role in the pathogenesis of ventilator-associated pneumonia (VAP).

OBJECTIVES

To determine the impact of continuous control of tracheal cuff pressure (P(cuff)) on microaspiration of gastric contents.

METHODS

Prospective randomized controlled trial performed in a single medical intensive care unit. A total of 122 patients expected to receive mechanical ventilation for at least 48 hours through a tracheal tube were randomized to receive continuous control of P(cuff) using a pneumatic device (intervention group, n = 61) or routine care of P(cuff) (control group, n = 61).

MEASUREMENTS AND MAIN RESULTS

The primary outcome was microaspiration of gastric contents as defined by the presence of pepsin at a significant level in tracheal secretions collected during the 48 hours after randomization. Secondary outcomes included incidence of VAP, tracheobronchial bacterial concentration, and tracheal ischemic lesions. The pneumatic device was efficient in controlling P(cuff). Pepsin was measured in 1,205 tracheal aspirates. Percentage of patients with abundant microaspiration (18 vs. 46%; P = 0.002; OR [95% confidence interval], 0.25 [0.11-0.59]), bacterial concentration in tracheal aspirates (mean ± SD 1.6 ± 2.4 vs. 3.1 ± 3.7 log(10) cfu/ml, P = 0.014), and VAP rate (9.8 vs. 26.2%; P = 0.032; 0.30 [0.11-0.84]) were significantly lower in the intervention group compared with the control group. However, no significant difference was found in tracheal ischemia score between the two groups.

CONCLUSIONS

Continuous control of P(cuff) is associated with significantly decreased microaspiration of gastric contents in critically ill patients.