During artificial ventilation in intensive care, a ventilation tube is inserted into the patient’s throat, taking air directly to the lungs. In one in four patients, using a tube leads to pneumonia. The new VUB and UZ Brussel spin-off Presscuff wants to bring the first pressure-based endotracheal tube to market, to greatly reduce the occurrences of pneumonia in intensive care patients. It was developed by former UZ Brussel intensive care nurse Emiel Suijs, with former head of intensive care and VUB professor Spapen.
When using conventional endotracheal tubes, fluids such as saliva often run down the outside of the tube directly into the lungs. As these fluids contain lots of bacteria, in one in four cases it leads to ventilator-associated pneumonia (VAP), in patients who are already weakened. Academic studies show that 10 to 15% of these patients die of pneumonia.
Tubes with a balloon (or cuff) proved insufficient
Researchers have previously tried to prevent these fluids entering by using a balloon or cuff around the tube. They can be inflated to stop leakage. However, leaks proved impossible to stop, as the cuff cannot be inflated too far to avoid damage to the trachea. In addition, each trachea is different in shape and size. Small openings or channels always develop in the cuff, through which fluids can seep. Alternatives such as other shapes of cuffs, cuffs made of new materials and multiple cuffs offered no solution.
Presscuff uses small openings to hold back liquids
Emiel Suijs, co-founder of Presscuff and former head nurse at the UZ Brussel intensive care unit, is behind the idea for the new tube, with former head of the unit and VUB professor Dr Spapen.
"With the advent of the Covid pandemic, much has changed and VAP has returned as a major problem in intensive care units around the world. The name Presscuff is a conjunction of ’pressure’, the air pressure used, and the two balloons, the ’cuffs’. The product has been tested both in vitro and in vivo. In the 12 patients tested, there was no run-through when using the Presscuff."
Professor Marc Noppen, CEO of UZ Brussel: "I think it’s great that an ICU nurse with years of experience at patients’ bedsides has come up with a solution to prevent a serious complication - ventilator-associated pneumonia - and developed and tested it, and founded a company with it. This is a perfect example of innovation on the shop floor."
VUB Professor Hugo Thienpont, vice-rector for Innovation and Valorisation: "We are delighted that the work started by Emiel Suijs and Dr Spapen is being continued by Emiel and VUB alumnus Evert Van Meeuwen. With this spin-off, the Vrije Universiteit Brussel and UZ Brussel are creating a solution to a common medical complication. Thus, we’re combining innovative research and collaboration to solve this challenge."
Presscuff has been patented and the first endotracheal tubes have been produced and tested in patients
Evert Van Meeuwen, co-founder Presscuff, CFA: "I’ve been involved in this project since 2018 and am very happy that now, with Miel (Emiel Suijs) and Jan (Vanden Abeele) we can establish Presscuff as a spin-off from VUB and UZ Brussel! Initial contacts in the US have been made. In addition, Prof Stijn Blot (UGent) and Prof Joop Jonckheer (UZ Brussel) will join Presscuff’s advisory board. These are professors with a very strong background and practical experience in the area. We realise we still have a long way to go, but really believe the Presscuff tube will be able to help patients and possibly even save lives. Before the product can be launched on the market, CE certification needs to be put in place and a wider medical examination will begin. The company is seeking additional staff and funding for this."
How does the Presscuff work?
Instead of trying to close the small openings in the trachea, the Presscuff tube uses these openings to hold back secretions. Air pressure is injected between two cuffs. This air pressure tries to escape through the channels of the cuffs, both upwards and downwards. With this air escaping upwards through the channels, the fluids cannot run downwards.
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