Abstract
Airway management techniques are aimed at reducing complications associated with artificial airways and mechanical ventilation, such as retained secretions. The impact of airway management techniques on ventilator-associated events (VAEs) varies considerably by modality. Closed-suction techniques are generally recommended but have limited, if any, impact on VAEs. Normal saline instillation during suctioning is not recommended. Devices designed specifically to remove biofilm from the inside of endotracheal tubes appear to be safe, but their role in VAE prevention is uncertain. Subglottic secretion clearance by artificial cough maneuvers is promising, but more research is needed to assess its clinical feasibility. Continuous cuff-pressure management appears to be effective in reducing microaspiration of subglottic secretions.
- airway management
- ventilator-associated event
- mechanical ventilation
- ventilator-associated pneumonia
- suctioning
- biofilm
- subglottic drainage
- cuff pressure
Footnotes
- Correspondence: J Brady Scott MSc RRT RRT-ACCS AE-C FAARC, Rush University, Department of Cardiopulmonary Sciences, Division of Respiratory Care, Armour Academic Center, 600 S Paulina St, 751 AAC, Chicago, IL 60607. E-mail: jonathan_b_scott{at}rush.edu
Mr Scott presented a version of this paper at the New Horizons in Respiratory Care Symposium: Ventilator Associated Events – Surveillance and Understanding at the AARC Congress 2018, held December 4-7, 2018, in Las Vegas, Nevada.
Mr Scott has disclosed a relationship with Ventec Life Systems. Ms Dexter has disclosed no conflicts of interest.
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