Evidence map›Paper›PMID 32838740›Full record

Trial reportBMC anesthesiology2020

Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia.

Ross P Martini, N David Yanez, Miriam M Treggiari, Praveen Tekkali, Cobin Soelberg, Michael F Aziz

Registry-linked trialOpen access · goldAbstract readClinical Trial
In one paragraph

Trial report in BMC anesthesiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02450929 (Prospective Clinical Evaluation of the Taperguard Endotracheal Tube), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02450929 completednot on this map

Prospective Clinical Evaluation of the Taperguard Endotracheal Tube

TypeobservationalSponsorOregon Health and Science UniversityRan2012 to 2016Enrolled102ConditionsPostoperative Pneumonia
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Ross P MartiniDepartment of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Oregon, USA.
N David YanezDepartment of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Oregon, USA.
Miriam M TreggiariDepartment of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Oregon, USA. miriam.treggiari@yale.edu.ORCID 0000-0003-4639-3682
Praveen TekkaliDepartment of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Oregon, USA.
Cobin SoelbergDepartment of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Oregon, USA.
Michael F AzizDepartment of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Oregon, USA.
Oregon Health & Science University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Covidien No numberNCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

backgroundEndotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-shaped cuff. We compared risk of postoperative pneumonia using the TaperGuard™ ETT and the standard ETT in surgical patients requiring general anesthesia with endotracheal intubation.

methodsWe used an interrupted time-series design to compare endotracheal intubation using the TaperGuard™ ETT (intervention cohort), and a historic cohort using the standard ETT (baseline cohort), among surgical patients requiring hospital admission. We compared the incidence of postoperative pneumonia in the intervention and baseline cohorts. Data were collected from the electronic health record and linked to patient-level data from National Surgical Quality Improvement Project. Additionally, we performed secondary analyses in a subgroup of patients at high risk of postoperative pneumonia.

results15,388 subjects were included; 6351 in the intervention cohort and 9037 in the baseline cohort. There was no significant difference in the incidence of postoperative pneumonia between the intervention cohort (1.62%) and the baseline cohort (1.79%). The unadjusted odds ratio (OR) of postoperative pneumonia was 0.90 (95% CI: 0.70, 1.16; p = 0.423) and the OR adjusted for patient characteristics and potential confounders was 0.90 (95% CI: 0.69, 1.19; p = 0.469), comparing the intervention and baseline cohorts. There was no a priori selected subgroup of patients for whom the use of the TaperGuard™ ETT was associated with decreased odds of postoperative pneumonia relative to the standard ETT. Hospital mortality was higher in the intervention cohort (1.5%) compared with the baseline cohort (1.0%; OR 1.46, 95% CI: 1.09, 1.95; p = 0.010).

conclusionsThe broad implementation of the use of the TaperGuard™ ETT for intubation of surgical patients was not associated with a reduction in the risk of postoperative pneumonia. In the setting of a low underlying postoperative pneumonia risk and the use of recommended preventative VAP bundles, further risk reduction may not be achievable by simply modifying the ETT cuff design in unselected or high-risk populations undergoing inpatient surgery.

trial registrationClinicalTrials.gov, ID NCT02450929 .

Indexed as

AdultAgedCohort StudiesEquipment DesignFemaleHumansInterrupted Time Series AnalysisIntubation, IntratrachealMaleMiddle AgedPneumonia, Ventilator-AssociatedPostoperative ComplicationsRisk FactorsAspirationHospital acquired pneumoniaNosocomial infectionPostoperative complicationsVentilator associated pneumonia

Identifiers

PMID32838740
PMCPMC7446207
OpenAlexW3081496509

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.