{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T03:39:48Z","timestamp":1783136388249,"version":"3.54.6"},"reference-count":69,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2017,7,18]],"date-time":"2017-07-18T00:00:00Z","timestamp":1500336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:p>Microaspiration of contaminated oropharyngeal and gastric secretions is the main mechanism for ventilator-associated pneumonia (VAP) in critically ill patients. Improving the performance of tracheal tubes in reducing microaspiration is one potential means to prevent VAP. The aim of this narrative review is to discuss recent findings on the impact of tracheal tube design on VAP prevention. Several randomized controlled studies have reported that subglottic secretion drainage (SSD) is efficient in VAP prevention. Meta-analyses have reported conflicting results regarding the impact of SSD on duration of mechanical ventilation, and one animal study raised concern about SSD-related tracheal lesions. However, this measure appears to be cost-effective. Therefore, SSD should probably be used in all patients with expected duration of mechanical ventilation &gt; 48 h. Three randomized controlled trials have shown that tapered-cuff tracheal tubes are not useful to prevent VAP and should probably not be used in critically ill patients. Further studies are required to confirm the promising effects of continuous control of cuff pressure, polyurethane-cuffed, silver-coated, and low-volume low-pressure tracheal tubes. There is moderate evidence for the use of SSD and strong evidence against the use of tapered-cuff tracheal tubes in critically ill patients for VAP prevention. However, more data on the safety and cost-effectiveness of these measures are needed. Other tracheal tube-related preventive measures require further investigation.<\/jats:p>","DOI":"10.4187\/respcare.05492","type":"journal-article","created":{"date-parts":[[2017,7,18]],"date-time":"2017-07-18T20:45:21Z","timestamp":1500410721000},"page":"1316-1323","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":28,"title":["Tracheal Tube Design and Ventilator-Associated Pneumonia"],"prefix":"10.1177","volume":"62","author":[{"given":"Anahita","family":"Rouz\u00e9","sequence":"first","affiliation":[{"name":"Centre de R\u00e9animation, CHU Lille, Lille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Jaillette","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9animation, CHU Lille, Lille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Poissy","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9animation, CHU Lille, Lille, France."},{"name":"Facult\u00e9 de M\u00e9decine, University of Lille, Lille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Pr\u00e9au","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9animation, CHU Lille, Lille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Nseir","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9animation, CHU Lille, Lille, France."},{"name":"Facult\u00e9 de M\u00e9decine, University of Lille, Lille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,7,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2011.04.011"},{"key":"e_1_3_2_3_2","unstructured":"European Center for Disease Prevention and Control. Annual Epidemiological Report 2011: reporting on 2009 surveillance data and 2010 epidemic intelligence data. Stockholm: ECDC; 2011. http:\/\/www.ecdc.europa.eu. Accessed April 10 2017."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2014.05.029"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.16226"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70081-1"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1368-4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.2174\/187152611796504827"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000158"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000123"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02868"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001414"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1527-7"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000674"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.119.1.228"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1086\/657943"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201412-2316OC"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000142575.86468.9B"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2013.02.007"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200906-0838OC"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1086\/677144"},{"key":"e_1_3_2_22_2","first-page":"A663","article-title":"Preliminary evaluation of a novel strategy to aspirate subglottic secretions following intubation with standard endotracheal tubes","volume":"3","author":"Li Bassi G","year":"2016","unstructured":"Li Bassi G, , Senussi T, , Idone F, , Aguilera Xiol E, , Travierso E, , Chiurazzi C, et al. Preliminary evaluation of a novel strategy to aspirate subglottic secretions following intubation with standard endotracheal tubes. Intensive Care Med Exp, 2016; 3(Suppl 1):A663, P140.","journal-title":"Intensive Care Med Exp"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201506-346OC"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-122-3-199502010-00004"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e3283222b6e"},{"issue":"5","key":"e_1_3_2_26_2","first-page":"440","article-title":"Continuous control of tracheal cuff pressure for the prevention of ventilator-associated pneumonia in critically ill patients: where is the evidence?","volume":"19","author":"Rouz\u00e9 A","year":"2013","unstructured":"Rouz\u00e9 A, , Nseir S. Continuous control of tracheal cuff pressure for the prevention of ventilator-associated pneumonia in critically ill patients: where is the evidence?. Curr Opin Crit Care, 2013; 19(5):440\u2013447.","journal-title":"Curr Opin Crit Care"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0417-x"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen355"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03387"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-015-0054-z"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201104-0630OC"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-016-0200-2"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000266686.95843.7D"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc13837"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-015-0087-3"},{"key":"e_1_3_2_36_2","unstructured":"Simple mechanical device to control pressure in the balloon of the endotracheal tube to prevent ventilator-acquired pneumonia. ClinicalTrials.gov. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02514655. Accessed April 10 2017."},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1380-8"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-003-1933-6"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq202"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-011-2145-0"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-1892-7"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2010.05.035"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000297888.82492.31"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.08.052"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200705-761OC"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2016.11.007"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201408-1398OC"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-014-1849-z"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2253-13-50"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201502-0206ED"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2011.02542.x"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc8461"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-1438"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12119"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001053"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02278"},{"key":"e_1_3_2_57_2","article-title":"Impact of tracheal cuff shape on microaspiration of gastric contents in intubated critically ill patients: study protocol for a randomized controlled trial","author":"Jaillette E","unstructured":"Jaillette E, , Girault C, , Brunin G, , Zerimech F, , Chiche A, , Broucqsault-Dedrie C, et al. Impact of tracheal cuff shape on microaspiration of gastric contents in intubated critically ill patients: study protocol for a randomized controlled trial. Intensive Care Med. doi: 10.1186\/s13063-015-0955-z.","journal-title":"Intensive Care Med"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1177\/0300060515581670"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001340051014"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc11357"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.3.863"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000242154.49632.B0"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181cd12b8"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.7.805"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1086\/599005"},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04363"},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04996"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-4-92"},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000201406.57821.5B"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu483"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.05492","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.05492","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.05492","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T07:34:56Z","timestamp":1779435296000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.05492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,18]]},"references-count":69,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.4187\/respcare.05492"],"URL":"https:\/\/doi.org\/10.4187\/respcare.05492","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2017,7,18]]}}}