Inefficient secretion removal is causing major problems
Globally, many Intensive Care Units are suffering from inefficient secretion removal, as this causes high infection rates, higher contamination risks between staff and patients, and is very costly for the units. Today, the best option for removing secretion below the cuff is inserting af plastic suctioning catheter (similar to a very small vacuum cleaner) via the endotracheal tube or tracheostomy tube, and suction out the secretion below the cuff.
This standard of care solution presents multiple issues:
High risk of lung infections. The suctioning catheter can only remove fluids and thin secreionts, whereas the thicker secretion remains in the airways and will over time drain into the distal bronchi and cause lung infections.
Tracheal wall damage. When the suctioning catheter is inserted, the staff really does not have control over where the tip of the catheter is placed. If placed up against the tracheal wall and the suctioning begins, the catheter will pull on the tracheal wall causing damage.
High risk of loosing PEEP. As the patient is being suctioned they cannot be ventilated simultaneously. Therefore, the staff has to be quick, but also firm, when suctioning the patient. But, when suctioning the catheter will also "suction" out the air of the lungs, and cause the patient to loose their PEEP.
An extremely uncomfortable procedure for the patient. The patient cannot be ventilated while suctioning, and having a "small vacuum cleaner" (the suctioning catheter) inserted via the intubation tube into the airways, and suction out the secretion, is a very uncomfortable procedure for the patient.