Monitoring of endotracheal tube cuff pressure in occurrence of ventilator associated pneumonia in neuro-critically ill patients

Abstract

Background: Ventilator-associated pneumonia (VAP) is a significant complication in mechanically ventilated patients, increasing morbidity and mortality. Maintaining optimal endotracheal tube cuff pressure is crucial for prevention. Objective: To evaluate the impact of 4-h versus 8-h endotracheal tube cuff pressure monitoring on VAP incidence in neuro-critically ill patients. Methods: Eighty neuro-critically ill patients in the intensive care units of Alexandria university hospitals who received endotracheal intubation and underwent mechanical ventilation for more than 48 h were divided into two equal groups of 40 cases. Endotracheal tube cuff pressure was monitored in the observation group at 8-h intervals, and in the study group every 4 h, and adjusted to 30 cmH2O. Incidence of ventilator-associated pneumonia (VAP) was compared between the two groups for 7 days. Results: By day 7, VAP incidence was 40% (16/40) in the observation group and 25% (10/40) in the study group (p > 0.05). No significant difference was found between groups regarding the proportion of time with acceptable cuff pressure. Conclusion: In neuro-critically ill patients, 8-h endotracheal tube cuff pressure monitoring appears feasible for VAP management without a statistically significant increase in incidence compared to 4-h monitoring.