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TELEFLEX ISIS® Better access. Best practice.
SUBGLOTTIC SECRETION REMOVAL:
A VAP REDUCTION STRATEGY
Ventilator-Associated Pneumonia (VAP) is a nosocomial pneumonia that develops more than 48 hours after endotracheal intubation.1 It is one of the most common infections acquired by adults
and children in intensive care units (ICUs) and is a cause of significant patient morbidity and mortality, increased utilization of healthcare resources and excess cost.2
During mechanical ventilation, secretions from the upper
respiratory tract accumulate above the endotracheal tube
cuff. Studies have shown that these secretions can seep past the cuff into the lower tract, increasing the incidence of ventilator-associated pneumonia.3 Drainage of the subglottic secretions has been demonstrated as an effective strategy in reducing early-onset VAP.4
THE CLINICAL CHALLENGE
The endotracheal tube chosen for initial intubation doesn’t always allow for easy access to this valuable practice—until now. That is why we created the Teleflex ISIS with an attachable suction line. The versatile design eliminates the need to be selective during initial intubation, increasing the number of patients who can be viable candidates for subglottic secretion suctioning, a clinically proven strategy for VAP reduction.2
1 American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005;171:388.
2 Coffin S MD, MPH, Klompas M MD, Classen D MD, et al. Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals. Infect Control Hosp Epidemiol 2008; 29:S31-S40.
3 American Thoracic Society. Consensus Statement: Hospital Acquired Pneumonia in Adults: diagnosis, assessment of severity, initial antimicrobial therapy and preventative strategies. Am J Respir Crit Care Med. 1996;151:1711-1725.
4 Dezfulian C, Shojania K, Collard HR, Kim HM, Matthay MA, Saint S. Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis. Am J Med 2005; 118:11-18.
HIGH VOLUME, LOW-PRESSURE CUFF• Effective seal at low pressures
• Design reduces pressure on the tracheal walls PILOT BALLOON
• Tactile feedback allows for a visual gauge of cuff inf lation
PLACEMENT RING • Provides a visual
depth indication to aid in proper tube placement
The unique convertible nature of the Teleflex ISIS frees clinicians from the uncertainty of choosing which tube is best for the patient at the time of intubation. Teleflex ISIS features an integrated suction port and separate suction line, allowing for subglottic secretion removal, on-demand. When needed, the suction tube attaches to the Teleflex ISIS via a secure locking connection. Both connection ports can be sealed upon disconnection, reducing the risk of exposure to patient secretions when not in use. This versatile design allows you to make the right choice, every time.
THE ISIS ADVANTAGE
• Convertible design
• Simplifies tube selection at initial intubation
• Use the suction line only when you need it
SUCTION LUMEN• Allows the removal of accumulated secretions
• Custom design reduces likelihood of mucus obstruction5
5 Pearce M, Mujica Lopez KI, Rubin BK et al. In vitro evaluation of endotracheal tubes with intrinsic suction. Virginia Commonwealth University School of Medicine, Department of Pediatrics Richmond, VA 23298 USA
TELEFLEX ISIS ENDOTRACHEAL TUBE FOR SUBGLOTTIC SECRETION SUCTIONING
SUCTION LINE WITH INTEGRATED CAPS • Design allows for easy connection to the suction port
• Easy handling when connecting suction tubing
• Caps seal suction line when not in use
• Sold separately
INTEGRATED SUCTION PORT• Design allows for easy
connection to the suction line
• Strategically designed for placement outside the patient’s mouth
• Cap seals suction port when not in use
EASY TO HOLD CONNECTOR• Custom designed connector
• Enables easy handling when connecting/disconnecting suction tubing
• No force applied on patient’s Endotracheal Tube (ETT)
USAGE REFERENCE GUIDE
**Distance from distal TIP to distal edge of purple integrated suction port on the endotracheal tube
STEP 1*: ATTACHING THE SUCTION LINE
Open the tethered cap on the purple
integrated suction port on the Teleflex ISIS
Endotracheal Tube.
Attach the Teleflex ISIS Suction Line by
aligning the two tabs on the purple suction
port on the endotracheal tube with the two
grooves in the round suction attachment
connector (Fig. 1).
Turn the suction connector clockwise (Fig. 2)
until the connector locks into place (Fig. 3).
STEP 2*: PREPARE WALL SUCTION
Set the suction regulator to the minimum
suction pressure required to effectively
remove subglottic secretions.
Continuous Suction: Less than -20 mmHg
Intermittent Suction: Between -100 and
-150 mmHg for 10-15 seconds6.
STEP 3*: ATTACH THE SUCTION LINE AND TUBING
Once the appropriate suction pressure is set
for subglottic secretion suctioning, attach
the distal end of the Teleflex ISIS suction
connector to suction tubing (Fig. 4).
To decrease the risk of tracheal tissue
obstructing the suction lumen without
decreasing suction efficacy:
1. Stop suction when there is no mucus flow.
2. Briefly reverse the suction flow if you notice a sudden increase in suction at the proximal port, as this suggests occlusion7.
CLEARING BLOCKAGES*
If the suction lumen becomes blocked,
attach a syringe to the machine end
connector and apply a bolus of up to 5 cc of
air into the suction system as shown (Fig. 5).
MAINTAIN APPROPRIATE CUFF PRESSURE*
Use a cuff pressure manometer like the
EndoTest™ (Fig. 6) to routinely
monitor cuff pressures.
TELEFLEX ISIS PRODUCT INFORMATION - RÜSCH®
CODE NO. PRODUCT DESCRIPTION OUTSIDE DIAMETER (OD)
CUFF RESTING DIAMETER
SUCTION PORT DISTANCE** QTY.
112662-000060 Endotracheal Tube, 6.0 mm 9.2 mm 21 mm 24.6 cm 10
112662-000065 Endotracheal Tube, 6.5 mm 9.9 mm 25 mm 24.6 cm 10
112662-000070 Endotracheal Tube, 7.0 mm 10.6 mm 26 mm 25.6 cm 10
112662-000075 Endotracheal Tube, 7.5 mm 11.3 mm 28 mm 25.6 cm 10
112662-000080 Endotracheal Tube, 8.0 mm 12.0 mm 28 mm 27.1 cm 10
112662-000085 Endotracheal Tube, 8.5 mm 12.6 mm 28 mm 27.5 cm 10
112662-000090 Endotracheal Tube, 9.0 mm 13.2 mm 29 mm 27.8 cm 10
502700 Suction Accessory Line 5
112700000 EndoTest 1
ORDERING INFORMATION
*Note: The following instructions are for example only
to help familiarize the clinician with its handling
of the product and do not represent the product’s
full instructions for use, including its associated
cautions and warnings. For a copy of complete
instructions, please see your sales representative.
FIGURE 3
6 AARC Clinical Practice Guidelines, [Respir Care 1993; 38 (5):500-504]
7 Mujica-Lopez KI, Pearce MA, Narron KA, Perez J, Rubin BK. In Vitro Evaluation of Endotracheal Tubes with Intrinsic Suction, CHEST 2010; 138(4):863-869.
FIGURE 6
FIGURE 4
FIGURE 5
FIGURE 1
FIGURE 2
SPACE FOR LOCAL CONTACT INFORMATION
(VARIABLE DATA)
Teleflex, EndoTest, ISIS and Rüsch are trademarks or registered trademarks of Teleflex Incorporated or its affiliates. © 2012 Teleflex Incorporated. All rights reserved. AJLA-AN-2012-0008-v1
Teleflex is a global provider of medical products designed to enable healthcare providers to protect against infections and improve patient and provider safety. The company specializes in products and services for vascular access, respiratory, general and regional anesthesia, cardiac care, urology and surgery. Teleflex also provides specialty products for device manufacturers. The Teleflex family of brands includes arrow®, beere medical®, deknatel®, gibeck®, hudson rci®, kmedic®, pilling®, pleur-evac®, rüsch®, sheridan®, smd®, taut®, tfx oem®, vasonova™ and weck®, all of which are trademarks or registered trademarks of Teleflex Incorporated or its affiliates. Teleflex Incorporated (nyse:tfx) has annual revenues of approximately $1.8 billion and customers in more than 130 countries.
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+1.919.433.4999 | [email protected] | TELEFLEX.COM
