Microbiological evaluation of a viscoelastic tracheal tube cuff in an in vitro aspiration model: a preliminary observational study

Summary Ventilator‐associated pneumonia is the most common intensive care unit‐acquired infection, driven by microaspiration of colonised secretions past the tracheal tube cuff. We performed a preliminary in vitro comparison of three tracheal tubes: a standard cylindrical cuff (Rusch ® , Teleflex Incorporated, PA, USA), a tapered cuff with subglottic suction (Shiley ® , Medtronic, MN, USA) and a novel self‐expanding viscoelastic cuff (V‐Cuff ® , Tianjin Medis Medical Device Co., Tianjin, China); using silicone artificial tracheas inoculated with Staphylococcus aureus (0.5 McFarland; approximately 1.5 × 10 8 colony‐forming units (CFU).ml −1 ). This was an exploratory single‐observation study (n = 1 per device). Over three 1‐hourly instillations of 20 ml, the V‐Cuff ® produced no fluid leakage or bacterial passage (0 ml; 0 CFU), versus 57.2 ml (> 10 8 CFU.ml −1 ) for the Rusch ® and 4.96 ml (approximately 10 6 CFU.ml −1 ) for the Shiley ® . The V‐Cuff ® also maintained a complete seal during high‐volume challenges simulating vomiting (300 ml) and massive flooding (2500 ml). These hypothesis‐generating findings support controlled investigation of the V‐Cuff ® as a strategy for preventing microaspiration.