Airway Management and Ventilator-Associated Events

Area of Science:

• Critical Care Medicine
• Respiratory Therapy
• Infectious Disease Prevention

Background:

• Artificial airways and mechanical ventilation can lead to complications, including retained secretions.
• Ventilator-associated events (VAEs) are significant concerns in mechanically ventilated patients.
• Various airway management techniques exist, but their efficacy in preventing VAEs is debated.

Purpose of the Study:

• To evaluate the impact of different airway management techniques on ventilator-associated events (VAEs).
• To assess the effectiveness of specific interventions in reducing complications associated with artificial airways.

Main Methods:

• Review of current literature on airway management techniques.
• Analysis of the impact of closed-suctioning, saline instillation, biofilm removal devices, artificial cough maneuvers, and cuff-pressure management on VAEs.
• Assessment of safety and efficacy data for novel airway management devices.

Main Results:

• Closed-suction techniques have minimal impact on VAEs.
• Normal saline instillation during suctioning is not recommended.
• Continuous cuff-pressure management effectively reduces microaspiration of subglottic secretions.
• The role of biofilm removal devices in VAE prevention remains uncertain.
• Subglottic secretion clearance by artificial cough maneuvers shows promise but requires further research.

Conclusions:

• Airway management strategies have a variable impact on VAEs.
• Continuous cuff-pressure management is a promising strategy for reducing microaspiration.
• Further research is needed to clarify the role of certain techniques and devices in VAE prevention.