Safety and Efficacy of a Novel Automated Intelligent Suction Device (VapCare) Among Mechanically Ventilated Neurocritical Care Patients: A Prospective Randomized Trial.

M S Varnitha, P Murlidhara, Archana Sharma, V Sudhir, Shwetha S Naik, Dhritiman Chakrabarti

Abstract readRandomized Controlled Trial

In one paragraph

Trial report in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

M S VarnithaDepartment of Neuroanesthesia and Neurocritical Care, Apollo Hospitals, Bengaluru, India.

P MurlidharaDepartment of Oncoanesthesia, All India Institute of Medical Sciences, New Delhi, India.

Archana SharmaDepartment of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, III Floor, Faculty Building, Bengaluru, 560029, India. drarchana7anesthesia@gmail.com.ORCID 0009-0007-3105-0640

V SudhirDepartment of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, III Floor, Faculty Building, Bengaluru, 560029, India.

Shwetha S NaikDepartment of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, III Floor, Faculty Building, Bengaluru, 560029, India.

Dhritiman ChakrabartiDepartment of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, III Floor, Faculty Building, Bengaluru, 560029, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVentilator-associated pneumonia (VAP) is a significant concern in intensive care units (ICUs), affecting 7-32% of mechanically ventilated patients, which mounts to higher morbidity and mortality and extended hospital stays. Preventing VAP involves meticulous secretion management and oral hygiene, but in low-resource settings, VAP remains common owing to the absence of standardized oral care protocols. This randomized study assessed the efficacy and safety of the VapCare automated secretion management device in reducing microaspirations and improving clinical outcomes in ventilated patients.

methodsA single-center, open-label randomized trial was conducted involving adult neurocritical care patients requiring mechanical ventilation for 48 h or more, excluding tracheostomized patients and patients with bleeding disorders, difficult airways, or preexisting pneumonia. Participants were randomly assigned to a control group, receiving standard ICU care with manual oropharyngeal suctioning, or a study group, receiving VapCare management. We compared lung ultrasound scores (LUS), clinical pulmonary infection scores (CPIS), secretion volumes, tracheal cultures, and chest X-ray results from day 1 to day 5.

resultsThe VapCare group demonstrated a slower rise in LUS and CPIS compared to the control group. The median CPIS rose from 1 (interquartile range [IQR] 1-2) on the first day to 5 (IQR 2.75-6) on the fifth day in the control group versus 1 (IQR 0-2) on the first day to 3 (IQR 2-3) on the fifth day in the VapCare group (p < 0.001). The median LUS increased from 0 (IQR 0-2) on the first day to 6 (IQR 2-10) on the fifth in the control group, whereas the change was more muted in the VapCare group (0 [IQR 1-2] on the first day to 4 [IQR 2-6] on the fifth day [p < 0.001]). Additionally, chest X-ray scores were lower in the VapCare group (p = 0.028). Tracheal culture microbial growth and mortality were similar in both groups, but the length of ICU stay was significantly shorter in the VapCare group (p = 0.004). One patient in the VapCare group sustained mucosal erosions on the lip due to the VapCare mouthpiece.

conclusionsThe VapCare device effectively reduces microaspiration and mitigates lung changes, demonstrating its potential to reduce the burden of microaspiration and suctioning in ventilated patients.

Indexed as

Critical CarePneumonia, Ventilator-AssociatedRespiration, ArtificialAdultAgedFemaleHumansIntensive Care UnitsMaleMiddle AgedProspective StudiesSuctionClinical pulmonary infection scoreLung ultrasound scoreNeurocritical careSubglottic secretion drainageVapCare suction deviceVentilator-associated pneumonia

Identifiers

PMID40214890

DOI10.1007/s12028-025-02253-w

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