Critical Care (Nov 2022)

Use of an innovative cuff pressure control and subglottic secretions drainage system in COVID-19 ARDS patients undergoing pronation

  • Eloisa Sofia Tanzarella,
  • Gianmarco Lombardi,
  • Silvia Baroni,
  • Francesca Sarlo,
  • Salvatore Lucio Cutuli,
  • Simone Carelli,
  • Melania Cesarano,
  • Veronica Gennenzi,
  • Gabriele Pintaudi,
  • Joel Vargas,
  • Antonio Maria Dell’Anna,
  • Domenico Luca Grieco,
  • Andrea Urbani,
  • Massimo Antonelli,
  • Gennaro De Pascale

DOI
https://doi.org/10.1186/s13054-022-04225-4
Journal volume & issue
Vol. 26, no. 1
pp. 1 – 5

Abstract

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Abstract We conducted a proof of concept study where Anapnoguard endotracheal tubes and its control unit were used in 15 patients with COVID-19 acute respiratory distress syndrome. Anapnoguard system provides suction, venting, rinsing of subglottic space and controls cuff pressure detecting air leakage through the cuff. Alpha-amylase and pepsin levels, as oropharyngeal and gastric microaspiration markers, were assessed from 85 tracheal aspirates in the first 72 h after connection to the system. Oropharyngeal microaspiration occurred in 47 cases (55%). Episodes of gastric microaspiration were not detected. Patient positioning, either prone or supine, did not affect alpha-amylase and pepsin concentration in tracheal secretions. Ventilator-associated pneumonia (VAP) rate was 40%. The use of the AG system provided effective cuff pressure control and subglottic secretions drainage. Despite this, no reduction in the incidence of VAP has been demonstrated, compared to data reported in the current COVID-19 literature. The value of this new technology is worth of being evaluated for the prevention of ventilator-associated respiratory tract infections.

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