{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:45:39Z","timestamp":1777470339321,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2007,1,1]],"date-time":"2007-01-01T00:00:00Z","timestamp":1167609600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biological Research For Nursing"],"published-print":{"date-parts":[[2007,1]]},"abstract":"<jats:p>Ventilator-associated pneumonia (VAP) is a common nosocomial pneumonia that occurs in critically ill patients and results in mortality rates as high as 71%. Subglottic secretions (SSs) are a known risk factor. Several clinical trials have shown that continuous aspiration of subglottic secretions (CASS) reduces the risk of VAP by nearly half. Optimal suction pressure levels needed to efficiently evacuate viscous SSs are unknown. The purpose of this study was to describe SSs and the effective suction pressure (20 mmHg, 30 mmHg, 40 mmHg, and 50 mmHg) needed to maximize evacuation efficiency based on SS volume (2 ml, 4 ml, and 6 ml) and viscosity (watery, thick, and gel-like). A laboratory model was designed to replicate a human trachea. Thick secretions had the highest percentage of mean recovery representative of evacuation efficiency of SSs (mean recovery of 86%). The suction pressure of 30 mmHg had the highest overall mean of secretion recovery (83%) across all viscosity types and amounts. This study demonstrated that higher viscosity secretions were easier to evacuate than lower viscosity secretions when 30-mmHg suction pressure was applied. Management of secretion viscosity may assist in secretion removal and delay VAP development. With increased understanding of the molecular structure of SSs, there is the potential that clinicians will be able to manipulate secretion viscoelastic properties to maximize evacuation efficiency of the secretions. Further research is needed to identify safe suction pressures for optimal evacuation of SSs in human subjects.<\/jats:p>","DOI":"10.1177\/1099800406295517","type":"journal-article","created":{"date-parts":[[2006,12,15]],"date-time":"2006-12-15T11:28:14Z","timestamp":1166182094000},"page":"202-209","source":"Crossref","is-referenced-by-count":14,"title":["Subglottic Secretion Viscosity and Evacuation Efficiency"],"prefix":"10.1177","volume":"8","author":[{"given":"Pamela V.","family":"O\u2019Neal","sequence":"first","affiliation":[{"name":"College of Nursing, University of Alabama, Huntsville,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy L.","family":"Munro","sequence":"additional","affiliation":[{"name":"Adult Health Department of the School of Nursing, Virginia Commonwealth University, Richmond"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Jo","family":"Grap","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine of the Departments of Internal Medicine, Virginia Commonwealth University Health System, Virginia Commonwealth University, Richmond"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah M.","family":"Rausch","sequence":"additional","affiliation":[{"name":"Department of Psychology, Virginia Commonwealth University, Richmond"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2007,1,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.3233\/BIR-1970-7104"},{"key":"atypb2","volume-title":"Adult health nursing","author":"Beare, P. G.","year":"1998","edition":"3"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000142575.86468.9B"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1136\/ebn.8.4.114"},{"key":"atypb5","first-page":"1","volume":"3","author":"Centers for Disease Control and Prevention","year":"2004","journal-title":"Morbidity and Mortality Weekly Review"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1016\/0007-0971(74)90045-X"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-6-200303180-00015"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-129-6-199809150-00002"},{"key":"atypb9","first-page":"259","volume":"36","author":"Curran, J. F.","year":"1991","journal-title":"Respiratory Care"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1007\/BF02112989"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2004.07.051"},{"key":"atypb12","first-page":"906","volume":"50","author":"Diaz, E.","year":"2005","journal-title":"Respiratory Care"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-141-4-200408170-00011"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1007\/BF01705418"},{"key":"atypb15","doi-asserted-by":"publisher","DOI":"10.2307\/30148490"},{"key":"atypb16","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.4.9807050"},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.2.555"},{"key":"atypb18","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/137.3.707"},{"key":"atypb19","doi-asserted-by":"publisher","DOI":"10.1378\/chest.116.5.1339"},{"key":"atypb20","first-page":"37","volume":"37","author":"Knaus, W. A.","year":"2002","journal-title":"Archives of Surgery"},{"key":"atypb21","doi-asserted-by":"publisher","DOI":"10.1007\/BF01706421"},{"key":"atypb22","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(96)00160-5"},{"key":"atypb23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1991.tb00321.x"},{"key":"atypb24","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-004-2238-0"},{"key":"atypb25","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.1.170"},{"key":"atypb26","unstructured":"O\u2019Neal, P. V. (2000).\n                      Factors associated with subglottic secretion accumulation and removal\n                      . Unpublished doctoral dissertation, Virginia Commonwealth University. (UMI No. 9988303)"},{"key":"atypb27","first-page":"290","volume":"11","author":"O\u2019Neal, P. V.","year":"2002","journal-title":"American Journal of Critical Care"},{"key":"atypb28","doi-asserted-by":"publisher","DOI":"10.1054\/iccn.2001.1604"},{"key":"atypb29","doi-asserted-by":"publisher","DOI":"10.1177\/0115426504019006597"},{"key":"atypb30","doi-asserted-by":"publisher","DOI":"10.1053\/jcan.2003.4"},{"key":"atypb31","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.154.1.8680665"},{"key":"atypb32","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000181731.53912.D9"},{"key":"atypb33","doi-asserted-by":"publisher","DOI":"10.1177\/00220345870660S209"},{"key":"atypb34","doi-asserted-by":"publisher","DOI":"10.3233\/BIR-1988-251-225"},{"key":"atypb35","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2001.450206.x"},{"key":"atypb36","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199501001-00051"},{"key":"atypb37","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-122-3-199502010-00004"},{"key":"atypb38","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9969(88)90134-3"},{"key":"atypb39","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-87553-3"},{"key":"atypb40","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/80.6.796"}],"container-title":["Biological Research For Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1099800406295517","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1099800406295517","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:38:45Z","timestamp":1777383525000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1099800406295517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,1]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2007,1]]}},"alternative-id":["10.1177\/1099800406295517"],"URL":"https:\/\/doi.org\/10.1177\/1099800406295517","relation":{},"ISSN":["1099-8004","1552-4175"],"issn-type":[{"value":"1099-8004","type":"print"},{"value":"1552-4175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,1]]}}}