1 Recommendations

Guidance

1.1 PneuX shows promise for preventing ventilator-associated pneumonia in adults. However, there is currently not enough good-quality evidence to support the case for routine adoption in the NHS.

1.2 Research is recommended to address uncertainties about the clinical benefits of using PneuX. This research should:

assess whether PneuX reduces the incidence of ventilator-associated pneumonia in all people needing ventilation
compare PneuX with current NHS clinical practice, that is, the use of endotracheal tubes with subglottic drainage
evaluate PneuX within the care bundle for ventilator-associated pneumonia prevention
be clear about the criteria used to diagnose ventilator-associated pneumonia in the study.

Why the committee made these recommendations

PneuX is a tube placed through the mouth or through a small cut in the throat (tracheostomy) when someone needs a ventilator to help them breathe. It's designed to prevent ventilator-associated pneumonia (VAP) which can happen when secretions from the mouth leak past the tube into the lungs. PneuX has a tight seal to prevent leaks, and ports that a nurse can use to drain the secretions away from above the seal.

The evidence for the clinical effectiveness of PneuX is mainly from a trial that was done in people who were ventilated for a relatively short period of time after cardiac surgery. People in this trial were classed as high risk because of their age, or heart disease, or both. While they did have less VAP compared with people who were on a ventilator tube without drainage, it's not clear if the same benefits would be seen in people who are ventilated for other reasons and for longer periods of time. The use of a ventilator tube that allows secretions to be drained is regarded as best practice for VAP prevention. However, it's not clear from the current evidence if PneuX is better than other ventilator tubes with drainage.

PneuX shows promise for preventing VAP but further research is recommended.