Author/Authors :
Min Huang, Wei Department of Hospital Infection-Control - Xiamen Haicang Hospital, Xiamen, China , An Huang, Xu Medical College of Xiamen University, Xiamen, China , Ping Du, Yan Department of Respiratory Medicine - Zhongshan Hospital - Xiamen University - Teaching Hospital of Fujian Medical University, Xiamen, China , Xia Li, Liu Department of Respiratory Medicine - Fujian Medical University union Hospital - Zhongshan Hospital Xiamen University, Xiamen, China , Fang Wu, Fang Department of Respiratory Medicine - Fujian Medical University union Hospital - Zhongshan Hospital Xiamen University, Xiamen, China , Qing Hong, Shao Department of Respiratory Medicine - Fujian Medical University union Hospital - Zhongshan Hospital Xiamen University, Xiamen, China , Xuan Tang, Fang Department of Respiratory Medicine - Fujian Medical University union Hospital - Zhongshan Hospital Xiamen University, Xiamen, China , Qiang Ye, Zhang Department of Respiratory Medicine - Fujian Medical University union Hospital - Zhongshan Hospital Xiamen University, Xiamen, China
Abstract :
Background. Microaspiration of secretions around the tracheal cuff is a multifactorial process. Tracheal cuff shape might take a
major part in its occurrence. ,e rationale for producing a taper-shaped cuff is established on the assumption that compared to a
conventional cuff with a single fixed diameter, a continuum of minimum-to-maximum diameter sections might better fit the
tracheal walls. Objectives. The primary objective of this meta-analysis was to compare ventilator-associated pneumonia (VAP)
between tapered-cuff intubation and conventional-cuff intubation. ,e secondary objective was to compare intensive care unit
(ICU) mortality between tapered-cuff intubation and conventional-cuff intubation. Methods. We searched the Cochrane Library,
Embase, MEDLINE database through the PubMed search engine, and CINAHL from inception to April 2018. Randomized trials
comparing VAP and ICU mortality between tapered-cuff intubation and conventional-cuff intubation in intubated adults were
included. Two review authors assessed study quality and abstracted databasing on prespecified criteria independently. Results. We
pooled summary estimates from 5 trials evaluating tapered-cuff involving 774 participants. Compared to VAP, no statistically
significant difference was observed between the tapered-cuff and conventional-cuff groups (OR 0.82, CI 0.61–1.12, z = 1.24, and
p = 0.21). No statistically significant difference was observed between the tapered-cuff and conventional-cuff groups with ICU
mortality (OR 0.77, CI 0.55–1.08, z = 1.49, and p = 0.14). Conclusions. In this meta-analysis, the tapered-cuff tracheal tube may not
be superior to the standard-cuff tracheal tube in reducing VAP and ICU mortality
Keywords :
Tapered Cuff , Conventional Cuff , Pneumonia , Ventilated Patients
