An observational prospective study on incidence of Ventilator Associated Pneumonia (VAP) in patients with continuous endotracheal-tube cuff-pressure control system

Background: Ventilator Associated Pneumonia (VAP) is one of the most important nosocomial infections in the Intensive Care Unit (ICU), causing significant morbidity and mortality. Apart from other measures, prevention of the leakage of oro-pharyngeal secretions in the lungs, using Endotracheal Tube Cuff Pressure Control System (ETCPCS) is an important upcoming strategy. Aims: In order to evaluate the significance of continuous cuff pressure monitoring in intubated patients. Methods: A total of fifty patients, of either gender with age >18 years who were mechanically ventilated for more than 48 hours, after intubation maintaining standard aseptic techniques and adhering strictly to VAP prevention bundle,were observed. Pressure in the cuff was maintained around 20 to 30 cms H20. Patients’ vitals, general and systemic examination, ventilator parameters and other investigations like leucocyte count, arterial blood gas measurements, chest X-Ray, and tracheal tube culture were recorded. Results: The incidence and the incidence density of VAP were found to be 24% and 26.37 respectively. Out of the 12 (24%) confirmed VAP patients, 4 (33%) were early onset whereas 8(66%) were categorized as late onset VAP. Conclusion: Continuous cuff pressure measurement may be associated with the incidence of VAP in the lower range whereas the significance of other factors like the adequacy of nursing staff in the ICU cannot be ruled out.