Effectiveness of Continuous Automatic Endotracheal Cuff Pressure Monitoring in Preventing Ventilator-Associated Pneumonia in the Pediatric Intensive Care Unit: A Randomized Controlled Trial
Primary result · Proportion of patients developing VAPResult — go to the resultRisk difference −10.6 percentage points 95% CI −20.3 to −0.8Authors' conclusion
CACPM significantly reduces the proportion of critically ill pediatric patients developing VAP compared with IMCPM. This preventive effect appears directly linked to improved target pressure compliance, suggesting that automated regulation could be a valuable addition to pediatric VAP prevention strategies.
Study context
- Population
- Critically ill pediatric patients requiring mechanical ventilation for ≥48 hours
- Participants
- 241 randomized patients
- Comparison
- Continuous automatic cuff pressure monitoring (CACPM) compared to intermittent manual cuff pressure monitoring (IMCPM)
- Primary endpoint
- Proportion of patients developing VAP
- Follow-up
- Within 28 days following intubation
Methodological details1:1 randomization, intention to treat analysis
- 1:1 randomization
- Intention to treat analysis
Primary result
As reported in the abstract
Risk difference
−10.6 percentage points
95% CI −20.3 to −0.8
P = 0.034
By group
CACPM vs IMCPM
risk difference −10.6 percentage points (95% CI −20.3 to −0.8); P = 0.034
Secondary outcomes
Proportion of patients developing VAP, per-protocol analysis · PP analysis
P = 0.044
| Outcome | CACPM | IMCPM | Estimate | P value | |
|---|---|---|---|---|---|
| VAP incidence densityOrder of groups for the IRR not printed · ITT analysis | 15.7 per 1,000 ventilator-days | 27.1 per 1,000 ventilator-days | IRR 1.73 (95% CI 0.94–3.18) | P = 0.080 | |
| Time to VAP diagnosisOrder of groups not printed · multivariable Cox proportional hazard regression | HR for VAP, unadjusted 1.80 (95% CI 0.976–3.321) | P = 0.060 | |||
| Time to VAP diagnosisHigher VAP hazard with IMCPM · multivariable Cox proportional hazard regression | HR for VAP, adjusted 1.90 (95% CI 1.024–3.510) | P = 0.042 | |||
| 0.20.5125Ratio (log scale) |
| Outcome | P value |
|---|---|
| Target-pressure complianceHigher with CACPM | P < 0.001 |
Original publication
Effectiveness of Continuous Automatic Endotracheal Cuff Pressure Monitoring in Preventing Ventilator-Associated Pneumonia in the Pediatric Intensive Care Unit: A Randomized Controlled Trial. Chest. Published 10 October 2026. doi:10.
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