Potential Mucosal Injury Related to Continuous Aspiration of Subglottic Secretion Device

Abstract

ASPIRATION of oropharyngeal secretions that pool above the cuff of the endotracheal tube has been one of many factors implicated in the pathogenesis of ventilator-associated pneumonia.1–3 The advent of continuous aspiration of subglottic secretion (CASS) devices has generated interest in their potential to minimize ventilator-associated pneumonia risk, especially when prolonged tracheal intubation is anticipated.4–6 However, despite their potential benefits, there may be adverse consequences of device use that may only be recognized as use increases. We report two cases of tracheal injury that may be attributable to the use of a CASS device.