Search strategy and evidence selection

Search strategy and evidence selection

Search strategy

1. Databases were searched from inception to November 2014. The keyword "TaperGuard" was used for the searches. The number of citations found is in brackets after each database:

Ovid MEDLINE(R) In‑Process & Other Non‑Indexed Citations and Ovid MEDLINE(R) (14); Embase (via OVID) (39); Cochrane Library (1); CAB Abstracts (1); Web of Science Science Citation Index (7).

These citations were sifted through to find any relevant material, using the inclusion criteria in the 'Evidence selection' section below.

2. The internet was searched using the keywords 'TaperGuard'.

3. ClinicalTrials.gov, WHO ICTRP, and Current Controlled Trials were also searched for ongoing trials.

4. Information provided by the manufacturer in supporting this briefing was checked to identify any further information.

5. The manufacturer's website was thoroughly investigated.

6. Information provided by the manufacturer was thoroughly checked for relevant studies.

Evidence selection

The inclusion criteria were as follows:

  • Patients: mechanically ventilated patients who may be at risk of ventilator‑associated pneumonia (VAP), in an intensive care unit (ICU) or an intensive therapy unit (ITU).

  • Intervention: the TaperGuard Evac oral tracheal tube.

  • Comparator: conventional endotracheal tube.

  • Outcomes: any clinical efficacy and safety outcomes, including but not limited to:

    • incidence of VAP

    • length of ICU/ITU stay

    • length of hospital stay

    • incidence of secondary infection

    • incidence of aspiration

    • duration of mechanical ventilation

    • antibiotic usage

    • mortality

    • adverse events.

  • Study design: for effectiveness any controlled study will be included. For the safety aspect of the device, any controlled study, non‑controlled study and case report will be included. Any relevant systematic reviews and meta‑analysis will also be included. Proof‑of‑concept, basic science, and non‑English language studies will be excluded.