BACKGROUND To determine the safety and clinical efficacy of an innovative integrated airway system (AnapnoGuard™ 100 system) that continuously monitors and controls the cuff pressure (Pcuff), while facilitating the aspiration of subglottic secretions (SS). METHODS This was a prospective, single centre, open-label, randomized, controlled feasibility and safety trial. The primary endpoint of th...

Microaspiration of subglottic secretions through channels formed by folds in high volume-low pressure poly-vinyl chloride cuffs of endotracheal tubes is considered a significant pathogenic mechanism of ventilator-associated pneumonia (VAP). Therefore a series of prevention measures target the avoidance of microaspiration. However, although some of these can minimize microaspiration, benefits in...

Abstract Background Following endotracheal intubation, clearing secretions above the tube cuff decreases incidence of ventilator-associated pneumonia (VAP); therefore, subglottic secretion drainage (SSD) is widely advocated. Our group developed a novel technique to remove secretions, rapid-flow expulsion maneuver (RFEM). The objective this study was explore effectiveness and safety RFEM compare...

Dezfulian C, Shojania K, Collard HR, et al. Subglottic secretion drainage for preventing ventilator-associated pneumonia: a metaanalysis. Am J Med 2005;118:11–8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....

BACKGROUND Aspiration of subglottic secretions past the endotracheal tube (ETT) cuff is a prerequisite for developing ventilator-associated pneumonia (VAP). Subglottic secretion drainage (SSD) ETTs reduce aspiration of subglottic secretions and have demonstrated lower VAP rates. We compared the performance of seven SSD ETTs against a non-SSD ETT in preventing aspiration below inflated cuffs. ...

Conclusions Semirecumbent positioning, stress ulcer prophylaxis (sucralfate rather than H2 antagonists), aspiration of subglottic secretions, selective digestive tract decontamination, and oscillating beds reduce ventilator associated pneumonia (VAP) in select critically ill patients. No evidence currently supports specific methods of enteral feeding or increased frequency of ventilator circuit...

background critically ill patients under mechanical ventilation require frequent suctioning of airway secretion. closed suction permits suctioning without disconnection from ventilator; so it might decrease hypoxemia and infection rate. objectives this study aimed to evaluate the effect of closed tracheal suction system (ctss) versus open tracheal suction system (otss). patients and methods thi...

BACKGROUND Endotracheal intubation increases the risk for microaspiration of secretions around the tube cuff. Pepsin has been used as a biomarker for gastric aspiration. Amylase is a newer proposed biomarker for aspiration of oral contents. OBJECTIVE To assess the presence of pepsin and amylase in paired oral-tracheal secretions of adult patients treated with mechanical ventilation. METHODS...