Use of an innovative cuff pressure control and subglottic secretions drainage system in COVID-19 ARDS patients undergoing pronation

We conducted a proof of concept study where Anapnoguard endotracheal\r\ntubes and its control unit were used in 15 patients with COVID-19 acute\r\nrespiratory distress syndrome. Anapnoguard system provides suction,\r\nventing, rinsing of subglottic space and controls cuff pressure\r\ndetecting air leakage through the cuff. Alpha-amylase and pepsin levels,\r\nas oropharyngeal and gastric microaspiration markers, were assessed from\r\n85 tracheal aspirates in the first 72 h after connection to the system.\r\nOropharyngeal microaspiration occurred in 47 cases (55\%). Episodes of\r\ngastric microaspiration were not detected. Patient positioning, either\r\nprone or supine, did not affect alpha-amylase and pepsin concentration\r\nin tracheal secretions. Ventilator-associated pneumonia (VAP) rate was\r\n40\%. The use of the AG system provided effective cuff pressure control\r\nand subglottic secretions drainage. Despite this, no reduction in the\r\nincidence of VAP has been demonstrated, compared to data reported in the\r\ncurrent COVID-19 literature. The value of this new technology is worth\r\nof being evaluated for the prevention of ventilator-associated\r\nrespiratory tract infections.