{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:24:26Z","timestamp":1792466666317,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2015,3,1]],"date-time":"2015-03-01T00:00:00Z","timestamp":1425168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The occurrence of ventilator-associated pneumonia (VAP) is linked to the aspiration of contaminated pharyngeal secretions around the endotracheal tube. Tubes with cuffs made of polyurethane rather than polyvinyl chloride or with a conical rather than a cylindrical shape increase tracheal sealing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To test whether using polyurethane and\/or conical cuffs reduces tracheal colonization and VAP in patients with acute respiratory failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter, prospective, open-label, randomized study in four parallel groups in four intensive care units between 2010 and 2012. A cohort of 621 patients with expected ventilation longer than 2 days was included at intubation with a cuff composed of cylindrical polyvinyl chloride (n\u2009=\u2009148), cylindrical polyurethane (n\u2009=\u2009143), conical polyvinyl chloride (n\u2009=\u2009150), or conical polyurethane (n\u2009=\u2009162). We used Kaplan-Meier estimates and log-rank tests to compare times to events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>After excluding 17 patients who secondarily refused participation or had met an exclusion criterion, 604 were included in the intention-to-treat analysis. Cumulative tracheal colonization greater than 103 cfu\/ml at Day 2 was as follows (median [interquartile range]): cylindrical polyvinyl chloride, 0.66 (0.58\u20130.74); cylindrical polyurethane, 0.61 (0.53\u20130.70); conical polyvinyl chloride, 0.67 (0.60\u20130.76); and conical polyurethane, 0.62 (0.55\u20130.70) (P\u2009=\u20090.55). VAP developed in 77 patients (14.4%), and postextubational stridor developed in 28 patients (6.4%) (P\u2009=\u20090.20 and 0.28 between groups, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among patients requiring mechanical ventilation, polyurethane and\/or conically shaped cuffs were not superior to conventional cuffs in preventing tracheal colonization and VAP.<\/jats:p>\n                    <jats:p>Clinical trial registered with clinicaltrials.gov (NCT01114022).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201408-1398oc","type":"journal-article","created":{"date-parts":[[2015,1,13]],"date-time":"2015-01-13T16:47:23Z","timestamp":1421167643000},"page":"637-645","source":"Crossref","is-referenced-by-count":85,"title":["Randomized Intubation with Polyurethane or Conical Cuffs to Prevent Pneumonia in Ventilated 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