1. The following databases were searched from inception to July 2015 using the keyword "Pneux", "LoTrach", and "Lo Trach": Ovid MEDLINE(R) In‑Process & Other Non‑Indexed Citations and Ovid MEDLINE(R); Embase (via OVID); Cochrane Library; CAB Abstracts; Web of Science Science Citation Index.
These citations were sifted through to identify any relevant material, using the inclusion criteria in the 'Evidence selection' section below.
2. The internet was searched using the above keywords.
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.
The inclusion criteria were as follows:
Population: adult cardiac patients requiring ventilation in a critical care setting who are at high risk of developing ventilator‑associated pneumonia (VAP).
Intervention: the PneuX system, used for the prevention of ventilator‑associated pneumonia. It was formerly known as the Venner PneuX P.Y. ‑ VAP Prevention System and the Lo‑Trach system. It has also been referred as the PneuX VAP prevention system, the PneuX P.Y. system, and the Venner‑PneuX system.
Comparator: any other equivalent or similar technology aimed at VAP prevention, or conventional endotracheal or tracheal intubation 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
Study type: published randomised or non‑randomised controlled trials; published cohort studies. For safety aspect of the device published case report studies were included. Proof‑of‑concept, bench‑top or basic science studies were excluded.
Non‑English language studies were excluded.