An in vitro microbiological study comparing eight endotracheal tubes and their ability to prevent microaspiration

Introduction The major cause of ventilator-associated pneumonia (VAP) is the aspiration of bacteria-laden subglottic secretions past the cuff of the endotracheal tube (ETT) [1]. When the ETT cuff is inflated to the correct wall pressure, excess cuff material folds and causes involutions thereby forming channels, which allow leakage of subglottic secretions to the lungs [2]. Now, new ETT cuffs have been designed and subglottic ports added in order to prevent microaspiration. The PneuX tube has previously been shown to prevent leakage by eliminating cuff folds and other cuffs have shown variable improvements [3].