S01E20 PreVent 2 and Subglottic Secretion Drainage After Emergency Intubation (Lancet Respir Med)

On today’s PRISM Rounds we discuss PreVent 2, the multicenter randomized trial in The Lancet Respiratory Medicine (2025) testing whether a polyurethane cuff + subglottic secretion drainage (PU-EVAC) endotracheal tube improves outcomes after emergency intubation—and what the accompanying editorial argues about the real-world value of subglottic suction devices.We translate the methods and results into what matters on shift: CDC ventilator-associated event metrics (IVAC / possible VAP), workflow realities (cuff pressure checks, suction setup), and why “VAP reduction” only matters if it moves objective outcomes. We also step back to the 2016 AnnalsATS Deem et al. pilot trial as historical context—then return to the core question: should these tubes be routine in emergency intubations, or is it time to move on?Friendly ICU banter included (with love for RTs and nursing). Educational use only.Sources (PubMed):PreVent 2 (Lancet Respir Med, 2025):https://pubmed.ncbi.nlm.nih.gov/41319662/Deem et al. pilot (AnnalsATS, 2016): https://pubmed.ncbi.nlm.nih.gov/26523433/Tags#CriticalCare #ICU #MechanicalVentilation #AirwayManagement #Intubation #VAP #VentilatorAssociatedPneumonia #VentilatorAssociatedEvents #IVAC #SubglotticSuction #EndotrachealTube #RespiratoryTherapy #Nursing #FOAMed #MedEd #JournalClub #EvidenceBasedMedicine #LancetRespiratoryMedicine #AnnalsATS