{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:47:32Z","timestamp":1791251252386,"version":"4.1.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2013,2,19]],"date-time":"2013-02-19T00:00:00Z","timestamp":1361232000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Aspiration of colonized oropharyngeal secretions is a major factor in the pathogenesis of ventilator-associated pneumonia (VAP). A tapered-cuff endotracheal tube (ETT) has been demonstrated to reduce aspiration around the cuff. Whether these properties are efficacious in reducing VAP is not known.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This 2-period, investigator-initiated observational study was designed to assess the efficacy of a tapered-cuff ETT to reduce the VAP rate. All intubated, mechanically ventilated patients over the age of 18 were included. During the baseline period a standard, barrel-shaped-cuff ETT (Mallinckrodt Hi-Lo) was used. All ETTs throughout the hospital were then replaced with a tapered-cuff ETT (TaperGuard). The primary outcome variable was the incidence of VAP per 1,000 ventilator days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We included 2,849 subjects, encompassing 15,250 ventilator days. The mean \u00b1 SD monthly VAP rate was 3.29 \u00b1 1.79\/1,000 ventilator days in the standard-cuff group and 2.77 \u00b1 2.00\/1,000 ventilator days in the tapered-cuff group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .65). While adherence to the VAP prevention bundle was high throughout the study, bundle adherence was significantly higher during the standard-cuff period (96.5 \u00b1 2.7%) than in the tapered-cuff period (90.3 \u00b1 3.5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In the setting of a VAP rate very near the average of ICUs in the United States, and where there was high adherence to a VAP prevention bundle, the use of a tapered-cuff ETT was not associated with a reduction in the VAP rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.02278","type":"journal-article","created":{"date-parts":[[2013,9,24]],"date-time":"2013-09-24T04:26:19Z","timestamp":1379996779000},"page":"1582-1587","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":34,"title":["The Impact of Hospital-Wide Use of a Tapered-Cuff Endotracheal Tube on the Incidence of Ventilator-Associated Pneumonia"],"prefix":"10.1177","volume":"58","author":[{"given":"David L","family":"Bowton","sequence":"first","affiliation":[{"name":"Critical Care Section, Department of Anesthesiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Duncan","family":"Hite","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care, Allergy, and Immunology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Shayn","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of General Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Sherertz","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Wake Forest Baptist Health, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,2,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201001-0081CI"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.2.597"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2005.08.005"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1086\/651669"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000063087.93157.06"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2007.06.011"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70127-X"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2010.69"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181ce21af"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/656737"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182227d52"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2011.10.001"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer312"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.03.002"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.2.9805120"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.7.805"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/109629601750185316"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.3.858"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)12251-1"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481107700817"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.110239"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000196379.74305.e4"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.122.2.662"},{"issue":"4","key":"e_1_3_2_25_2","first-page":"891","article-title":"Prospective comparison of bronchoalveolar lavage and quantitative deep tracheal aspirate in the diagnosis of ventilator associated pneumonia","volume":"59","author":"Mondi MM","year":"2005","unstructured":"Mondi MM, , Chang MC, , Bowton DL, , Kilgo PD, , Meredith JW, , Miller PR. 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