Summary

Summary

The PneuX tube system is intended for airway management in critically ill patients who are having mechanical ventilation. It is designed to prevent ventilator‑associated pneumonia by minimising the risk of pulmonary aspiration and micro‑aspiration in patients having ventilation for 24 hours or more. One randomised controlled trial in high‑risk cardiac patients found that the PneuX system was associated with a statistically significant reduction in the incidence of ventilator‑associated pneumonia compared with a standard endotracheal tube. A PneuX endotracheal tube costs £150 and a PneuX tracheostomy tube costs £175 (both excluding VAT).

Product summary and likely place in therapy

  • PneuX is a endotracheal/ tracheostomy tube system for airway management designed to prevent ventilator‑associated pneumonia (VAP) in patients having ventilation for 24 hours or more.

  • The system could be used to replace standard endotracheal and tracheostomy tubes that have no subglottic drainage access, subglottic drainage access but with a high pressure cuff, or no continuous cuff‑pressure monitor.

Effectiveness and safety

  • One UK‑based randomised controlled trial in 240 high‑risk patients having cardiac surgery found that PneuX was associated with a significant reduction in VAP incidence compared with a standard endotracheal tube (10.8% compared with 21%, p=0.03). There was no statistically significant difference in any other outcome measures.

  • One UK‑based retrospective cohort study in a medical and surgical ICU reported VAP incidence of 6% in 48 patients with the PneuX system. Unplanned extubation was reported in 17% of patients; 10% of patients self‑extubated.

  • One UK‑based retrospective cohort study in 53 critically ill patients with the PneuX system found no incidence of VAP while the PneuX system was in place.

  • One UK‑based retrospective cohort study analysing records of 185 intubations using the PneuX system found that the incidence of unplanned extubations was 0.1% over 982 intubation days.

Technical and patient factors

  • The PneuX system consists of an endotracheal or tracheostomy tube, the PneuX tracheal seal monitor and an extension tube. The manufacturer recommends that the tube and monitor should only be used together and not with other devices.

  • The PneuX endotracheal/tracheostomy tube has multiple access ports for subglottic drainage and a low‑volume, low pressure cuff made from soft silicone. The PneuX tracheal seal monitor has a default setting to maintain a constant low pressure on the tracheal wall (30 cm H2O, which requires an intra‑cuff pressure of 80 cm H2O).

  • The PneuX endotracheal/tracheostomy tube is available in 3 sizes, with an inner diameter of 7.0, 8.0 or 9.0 mm. A smaller PneuX endotracheal tube with an inner diameter of 6.0 mm is also available. Both the PneuX endotracheal/tracheostomy tube and the extension tube are supplied sterile and for single use.

Cost and resource use

  • A single‑use PneuX endotracheal tube costs £150 (excluding VAT).

  • A single‑use PneuX tracheostomy tube costs £175 (excluding VAT).

  • The PneuX tracheal seal monitor is provided to the hospital on a loan basis.

  • The extension tube is provided at no charge to the hospital.