Abstract
BackgroundThe PneuX System is a novel endotracheal tube and tracheal seal monitor, which has been designed to minimise the aspiration of oropharyngeal secretions. We aimed to determine the incidence of ventilator-associated pneumonia (VAP) in patients who were intubated with the PneuX System and to establish whether intermittent subglottic secretion drainage could be performed reliably and safely using the PneuX System.FindingsIn this retrospective observational study, data was collected from 53 sequential patients. Nine (17%) patients were initially intubated with the PneuX System and 44 (83%) patients underwent elective exchange to the PneuX System. There were no episodes of VAP while the PneuX System was in situ. On an intention to treat basis, the incidence VAP was 1.8%. There were no complications from, or failure of, subglottic secretion drainage during the study.ConclusionsOur study demonstrates that a low incidence of VAP is possible using the PneuX System. Our study also demonstrates that elective exchange and intermittent subglottic secretion drainage can be performed reliably and safely using the PneuX System.
Highlights
Ventilator-associated pneumonia (VAP) can be defined as a pneumonia that occurs after more than 48 hours of intubation and mechanical ventilation [1]
Our study demonstrates that a low incidence of ventilatorassociated pneumonia (VAP) is possible using the PneuX System
Our study demonstrates that elective exchange and intermittent subglottic secretion drainage can be performed reliably and safely using the PneuX System
Summary
Ventilator-associated pneumonia (VAP) can be defined as a pneumonia that occurs after more than 48 hours of intubation and mechanical ventilation [1]. Subglottic secretion drainage (SSD) has been recommended to minimise the accumulation of secretions above the endotracheal tube (ETT) cuff [4-6]. This has been shown to reduce the incidence of VAP by approximately 50%, but requires the use of a compatible device such as the Hi-Lo Evac, SealGuard Evac, TaperGuard (Covidien, Massachusetts, USA), Portex SACETT (Portex, Hythe, UK) and the Teleflex ISIS HVT (Teleflex, Wisconsin, USA) [4,7,8]. Patients are intubated with a conventional ETT in the first instance. It should be noted that there is no evidence to suggest that electively reintubating a patient to exchange a conventional ETT to a SSD compatible device is associated with VAP [9]. We aimed to determine the incidence of ventilatorassociated pneumonia (VAP) in patients who were intubated with the PneuX System and to establish whether intermittent subglottic secretion drainage could be performed reliably and safely using the PneuX System
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