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:
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.
