Comparison of the Frequency of Ventilator-Associated Pneumonia in Intubated Patients Followed Up With Automatic Cuff Pressure Controller and Manual Cuff Pressure Controller in Pediatric Intensive Care

Inclusion Criteria: * Children aged 1 month to 18 years * Intubated and mechanically ventilated patients expected to require at least 48 hours of mechanical ventilation * Eligibility assessed and enrollment completed within 24 hours of intubation and initiation of mechanical ventilation Exclusion Criteria: * Previous intubation within 14 days before enrollment * Already receiving mechanical ventilation for more than 24 hours at the time of PICU admission or screening * Expected duration of mechanical ventilation less than 48 hours * Presence of tracheostomy * Trauma-related tracheomalacia * Stridor * Suspected or confirmed tracheal stenosis * Suspected or confirmed immunodeficiency * Current or previous malignancy * Chronic pulmonary, cardiac, or other systemic disease * Current use of immunosuppressive medications, including corticosteroids * Declined consent / refusal to participate