The need to reduce ventilator associated events is the primary reason the Shiley™ evac oral endotracheal tube with TaperGuard™ cuff is critical for all patients on a ventilator in the ICU.
Subglottic secretion drainage (SSD) helps remove oral and/or gastric secretions from above the endotracheal tube cuff before they can be aspirated. Such aspirations may lead to a very serious complication known as VAP or Ventilator Associated Pneumonia.
SSD must be done with a specialized endotracheal tube with a separate dorsal suction lumen located just above the cuff. Based upon clinical evidence, the following organizations recommend the use of SSD to reduce the incidence of VAP:
Friction or pressure between the tracheal cuff and the trachea’s sensitive mucosa can lead to irritation, ischemia and tracheal trauma.2,3
Endotracheal tubes with TaperGuard™ cuff technology have features that may help reduce the tracheal impact of intubation with a unique, taper-shaped cuff design that provides a smaller area of contact with the patient’s airway than traditional barrel-shaped cuffs.3
Tapered-cuff advantages
Unique TaperGuard™ cuff design:
The use of subglottic suctioning combined with the hospital-designed VAP or VAC bundle can:
Explore how TaperGuard™ cuff technology, featured on Shiley™ tracheostomy tubes, is designed to maximize comfort and safety for patients.
1. Muscedere J, Rewa O, McKechnie K, Jiang X, Laporta D, Heyland DK. Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and metaanalysis. Crit Care Med. 2011;39(8):1985–1991.
2. Liu J, Zhang X, Gong W. Correlations between controlled endotracheal tube cuff pressure and postprocedural complications: a multicenter study. Anesth Analg. 2010;111(5):1133–7.
3. Seegobin RD, van Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. Br Med J (Clin Res Ed). 1984;288(6422):965–968.
4. Lichtenthal PR, Wood L, Wong A, Borg U. Pressure applied to tracheal wall by barrel and taper shaped cuffs. Proc Am Soc Anesth Annual Meeting. 2011:A1054.
View Abstract5. Guard endotracheal tube intracuff pressure increase is less than that of the Hi-Lo tube during nitrous oxide exposure: a model trachea study. Anesth Analg. 2013;116: 609–612.
6. Lichtenthal PR, Wood L, Wong A, Borg U. Pressure applied to tracheal wall by barrel and taper shaped cuffs. Proc Am Soc Anesth. 2011: A1054.
7. Lichtenthal PR, Maul D, Borg U. Do tracheal tubes prevent microaspiration? Br J Anaesth. 2011;107(5):821–822.
