European journal of anaesthesiology
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Multicenter Study
Collaborative intervention to improve airway assessment and safety in management for anaesthesia: The Qualitat & Via Aèria (QUAVA) study.
Airway assessment and management are cornerstones of anaesthesia, yet airway complications remain an important source of morbidity. ⋯ The collaborative intervention was effective in improving airway assessment but not in changing difficult airway management practices.
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Ventilation-associated pneumonia (VAP) is the commonest nosocomial infection in intensive care. Implementation of a VAP prevention care bundle is a proven method to reduce its incidence. The UK care bundle recommends maintenance of the tracheal tube cuff pressure at 20 to 30 cmH₂O with 4-hourly pressure checks and use of tracheal tubes with subglottic aspiration ports in patients admitted for more than 72 h. ⋯ Subglottic secretions leaked past the tracheal tube cuff with all tube types and cuff pressure monitoring strategies in this model. Significantly higher rates were observed with continuous cuff pressure monitoring and significantly lower rates were observed when using a tracheal tube with a subglottic aspiration port. Further evaluation of medical device performance is needed in order to design more effective VAP prevention strategies.