Is the evidence for the use of subglottic drainage to prevent ventilated-associated pneumonia sufficient to change practice?

This paper critiques the systematic review and meta-analysis of the effect of subglottic drainage among patients who received mechanical ventilation. Subglottic secretion drainage can reduce bacterial pathogens from entering the lower respiratory tract and potentially reduce the occurrence of ventilator-associated pneumonia. A summary of the systematic review and meta-analysis is provided. The critique examines the study's strengths and weaknesses and implications for practice are discussed. It is a well-conducted systematic review and meta-analysis with few suggestions for improvement. Subglottic secretion drainage reduced the incidence of ventilator-associated pneumonia. Several studies have shown positive effects of using subglottic drainage but despite the evidence, the practice in ICUs is not widespread.