{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:07:54Z","timestamp":1792645674869,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurocrit Care"],"published-print":{"date-parts":[[2025,10]]},"DOI":"10.1007\/s12028-025-02253-w","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T02:36:27Z","timestamp":1744338987000},"page":"551-562","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety and Efficacy of a Novel Automated Intelligent Suction Device (VapCare) Among Mechanically Ventilated Neurocritical Care Patients: A Prospective Randomized Trial"],"prefix":"10.1007","volume":"43","author":[{"given":"M. S.","family":"Varnitha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Murlidhara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3105-0640","authenticated-orcid":false,"given":"Archana","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Sudhir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shwetha S.","family":"Naik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhritiman","family":"Chakrabarti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"issue":"6","key":"2253_CR1","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.1097\/01.CCM.0000128569.09113.FB","volume":"32","author":"MH Kollef","year":"2004","unstructured":"Kollef MH. Prevention of hospital-associated pneumonia and ventilator-associated pneumonia. Crit Care Med. 2004;32(6):1396\u2013405.","journal-title":"Crit Care Med"},{"issue":"4","key":"2253_CR2","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1164\/rccm.200405-644ST","volume":"171","author":"Guidelines for the management of adults with hospital-acquired","year":"2005","unstructured":"Guidelines for the management of adults with hospital-acquired. ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171(4):388\u2013416.","journal-title":"Am J Respir Crit Care Med"},{"issue":"5","key":"2253_CR3","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1093\/bja\/78.5.557","volume":"78","author":"PJ Young","year":"1997","unstructured":"Young PJ, Rollinson M, Downward G, Henderson S. Leakage of fluid past the tracheal tube cuff in a benchtop model. Br J Anaesth. 1997;78(5):557\u201362.","journal-title":"Br J Anaesth"},{"issue":"3","key":"2253_CR4","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.ajic.2003.05.001","volume":"32","author":"C Binkley","year":"2004","unstructured":"Binkley C, Furr LA, Carrico R, McCurren C. Survey of oral care practices in US intensive care units. Am J Infect Control. 2004;32(3):161\u20139.","journal-title":"Am J Infect Control"},{"issue":"21","key":"2253_CR5","doi-asserted-by":"publisher","first-page":"422","DOI":"10.21037\/atm.2018.10.40","volume":"6","author":"JC Lacherade","year":"2018","unstructured":"Lacherade JC, Azais MA, Pouplet C, Colin G. Subglottic secretion drainage for ventilator-associated pneumonia prevention: an underused efficient measure. Ann Transl Med. 2018;6(21):422.","journal-title":"Ann Transl Med"},{"issue":"8","key":"2253_CR6","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1097\/CCM.0b013e318218a4d9","volume":"39","author":"J Muscedere","year":"2011","unstructured":"Muscedere J, Rewa O, McKechnie K, Jiang X, Laporta D, Heyland DK. Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis. Crit Care Med. 2011;39(8):1985\u201391.","journal-title":"Crit Care Med"},{"issue":"1","key":"2253_CR7","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1186\/s13054-016-1527-7","volume":"20","author":"Z Mao","year":"2016","unstructured":"Mao Z, Gao L, Wang G, Liu C, Zhao Y, Gu W, et al. Subglottic secretion suction for preventing ventilator-associated pneumonia: an updated meta-analysis and trial sequential analysis. Crit Care Lond Engl. 2016;20(1):353.","journal-title":"Crit Care Lond Engl"},{"issue":"4","key":"2253_CR8","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1097\/CCM.0000000000001414","volume":"44","author":"DA Caroff","year":"2016","unstructured":"Caroff DA, Li L, Muscedere J, Klompas M. Subglottic secretion drainage and objective outcomes: a systematic review and meta-analysis. Crit Care Med. 2016;44(4):830\u201340.","journal-title":"Crit Care Med"},{"issue":"12","key":"2253_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v050.i12","volume":"50","author":"K Noguchi","year":"2012","unstructured":"Noguchi K, Gel YR, Brunner E, Konietschke F. nparLD: an R software package for the nonparametric analysis of longitudinal data in factorial experiments. J Stat Softw. 2012;50(12):1\u201323.","journal-title":"J Stat Softw"},{"issue":"5","key":"2253_CR10","first-page":"527","volume":"16","author":"EH Elpern","year":"1987","unstructured":"Elpern EH, Jacobs ER, Bone RC. Incidence of aspiration in tracheally intubated adults. Heart Lung J Crit Care. 1987;16(5):527\u201331.","journal-title":"Heart Lung J Crit Care"},{"key":"2253_CR11","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/BF01705418","volume":"21","author":"RJ Estes","year":"1995","unstructured":"Estes RJ, Meduri GU. The pathogenesis of ventilator-associated pneumonia: I. Mechanisms of bacterial transcolonization and airway inoculation. Intensive Care Med. 1995;21:365\u201383.","journal-title":"Intensive Care Med"},{"issue":"2","key":"2253_CR12","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/s00134-003-2077-4","volume":"30","author":"E Girou","year":"2004","unstructured":"Girou E, Buu-Hoi A, Stephan F, Novara A, Gutmann L, Safar M, et al. Airway colonisation in long-term mechanically ventilated patients. Effect of semi-recumbent position and continuous subglottic suctioning. Intensive Care Med. 2004;30(2):225\u201333.","journal-title":"Intensive Care Med"},{"issue":"5","key":"2253_CR13","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1097\/00003246-199905000-00020","volume":"27","author":"MJ Richards","year":"1999","unstructured":"Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit Care Med. 1999;27(5):887\u201392.","journal-title":"Crit Care Med"},{"issue":"2","key":"2253_CR14","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/cc13775","volume":"18","author":"AA Kalanuria","year":"2014","unstructured":"Kalanuria AA, Ziai W, Mirski M. Ventilator-associated pneumonia in the ICU. Crit Care Lond Engl. 2014;18(2):208.","journal-title":"Crit Care Lond Engl"},{"issue":"6","key":"2253_CR15","doi-asserted-by":"publisher","first-page":"e141","DOI":"10.4037\/ajcc2011178","volume":"20","author":"ML Sole","year":"2011","unstructured":"Sole ML, Penoyer DA, Bennett M, Bertrand J, Talbert S. Oropharyngeal secretion volume in intubated patients: the importance of oral suctioning. Am J Crit Care. 2011;20(6):e141\u20135. https:\/\/doi.org\/10.4037\/ajcc2011178.","journal-title":"Am J Crit Care"},{"issue":"1","key":"2253_CR16","doi-asserted-by":"publisher","first-page":"11906","DOI":"10.1038\/s41598-018-30494-7","volume":"8","author":"L Fern\u00e1ndez-Barat","year":"2018","unstructured":"Fern\u00e1ndez-Barat L, Ben-Aicha S, Motos A, Vila J, Marco F, Rigol M, Mu\u00f1oz L, Li Bassi G, Ferrer M, Torres A. Assessment of in vivo versus in vitro biofilm formation of clinical methicillin-resistant Staphylococcus aureus isolates from endotracheal tubes. Sci Rep. 2018;8(1):11906. https:\/\/doi.org\/10.1038\/s41598-018-30494-7.","journal-title":"Sci Rep"},{"issue":"1","key":"2253_CR17","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1186\/s13054-022-04225-4","volume":"26","author":"ES Tanzarella","year":"2022","unstructured":"Tanzarella ES, Lombardi G, Baroni S, Sarlo F, Cutuli SL, Carelli S, Cesarano M, Gennenzi V, Pintaudi G, Vargas J, Dell\u2019Anna AM, Grieco DL, Urbani A, Antonelli M, De Pascale G. Use of an innovative cuff pressure control and subglottic secretions drainage system in COVID-19 ARDS patients undergoing pronation. Crit Care. 2022;26(1):338. https:\/\/doi.org\/10.1186\/s13054-022-04225-4.","journal-title":"Crit Care"},{"issue":"1","key":"2253_CR18","first-page":"19","volume":"25","author":"PV O'Neal","year":"2014","unstructured":"O\u2019Neal PV, Grap MJ, Munro CL, Sessler CN, Elswick RK Jr, Sinks SZ. Subglottic secretion volume and viscosity: effect of systemic volume and oral hydration. Dynamics. 2014;25(1):19\u201325.","journal-title":"Dynamics"},{"issue":"5","key":"2253_CR19","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1111\/nicc.12586","volume":"27","author":"S Saseedharan","year":"2022","unstructured":"Saseedharan S, Karanam R, Kadam V, Shirsekar S. Smart secretion management to protect nurses from COVID19 and other infectious diseases. Nurs Crit Care. 2022;27(5):706\u201310. https:\/\/doi.org\/10.1111\/nicc.12586.","journal-title":"Nurs Crit Care"},{"key":"2253_CR20","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-1782766\/v1","author":"V Bhardwaj","year":"2022","unstructured":"Bhardwaj V, Alva A, Manoj A. Efficacy and safety of automated antiseptic lavage and suctioning of oral, oropharyngeal, and subglottic secretions (VapCare) among ventilated patients with COVID-19 developing ventilator-associated events during hospitalization: a prospective randomized open blinded end-point study. Res Sq. 2022. https:\/\/doi.org\/10.21203\/rs.3.rs-1782766\/v1.","journal-title":"Res Sq"},{"key":"2253_CR21","unstructured":"https:\/\/simexmed.de\/wp-content\/uploads\/2018\/08\/ds_m30plus_rev.00_2016-11-25__m30plus.pdf"},{"issue":"2","key":"2253_CR22","first-page":"e35909","volume":"6","author":"M Shamali","year":"2017","unstructured":"Shamali M, Abbasinia M, Babaii A, Abbasinia M, Shahriari M, Akbari Kaji M, et al. Effect of minimally invasive endotracheal tube suctioning on suction-related pain, airway clearance and airway trauma in intubated patients: a randomized controlled trial. Nurs Midwifery Stud. 2017;6(2):e35909.","journal-title":"Nurs Midwifery Stud"},{"issue":"3","key":"2253_CR23","doi-asserted-by":"publisher","first-page":"217","DOI":"10.4212\/cjhp.v62i3.791","volume":"62","author":"SK Gorman","year":"2009","unstructured":"Gorman SK, Stewart LM, Slavik RS, de Lemos J, Chittock D, Dhingra VK, Ronco JJ, Parwana H. Identifying missed opportunities to curtail antimicrobial therapy for presumed ventilator-associated pneumonia using the clinical pulmonary infection score. Can J Hosp Pharm. 2009;62(3):217\u201325. https:\/\/doi.org\/10.4212\/cjhp.v62i3.791.","journal-title":"Can J Hosp Pharm"}],"container-title":["Neurocritical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12028-025-02253-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12028-025-02253-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12028-025-02253-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T14:23:47Z","timestamp":1757946227000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12028-025-02253-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,11]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["2253"],"URL":"https:\/\/doi.org\/10.1007\/s12028-025-02253-w","relation":{},"ISSN":["1541-6933","1556-0961"],"issn-type":[{"value":"1541-6933","type":"print"},{"value":"1556-0961","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,11]]},"assertion":[{"value":"7 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest"}},{"value":"This study was approved by the institutional ethics committee, and written informed consent was obtained from the relatives of all the participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval\/informed consent"}}]}}