key: cord-0904463-mgzcvrd4
authors: Muramoto, Takashi; Aoki, Ayumi; Suzuki, Yuichiro; Hishida, Maki; Ohata, Ken
title: Continuous saliva suction tube to prevent aspiration pneumonia during upper GI endoscopy
date: 2020-12-10
journal: VideoGIE
DOI: 10.1016/j.vgie.2020.11.002
sha: 66c218f2a714d55746853efcf6ea566162132dda
doc_id: 904463
cord_uid: mgzcvrd4

nan

The device can be set as follows. First, place the mouthpiece as usual. Then fix the tube of the aspirator through the axilla and connect the aspirator tube to the Salsuction. Next, place the tip of the tube in the oral cavity. Finally, bend the Salsuction in 2 places and fix it to the bed ( Fig. 2A) . All of these settings can be completed in less than 30 seconds. The tube rarely interferes with the operation of the endoscope.

Several reports have described use of the device for continuous saliva suction. 1, 4 In one report, the device was attached to an endoscope to prevent aspiration during esophageal ESD, 1 but special settings were required, and continuous suction under all situations was difficult because the degree of suction was affected by the operation of the endoscope. Furthermore, although this method was useful for the suctioning of liquid pooling in the esophageal lumen to prevent backflow into the oral cavity, suctioning of saliva in the oral cavity itself was difficult.

In a second report, the suction tube was integrated into the mouthpiece 4 ; fine-tuning the position of the suction tube during the examination was difficult, depending on where the saliva was collecting. However, this device is inexpensive (costing about USD $3), easy to set up, can easily change suction position in the oral cavity when manipulated from outside the body, and can be used in all cases, regardless of the endoscopic manipulations. Because time-consuming treatments such as ESD, endoscopic hemostasis for the upper GI tract, and ERCP often increase saliva production, this device can be constantly used to prevent aspiration. Furthermore, because the risk of aspiration, regardless of the examination time, is high, this device can be used for procedures in elderly patients and for Lugol voiding during examinations. In addition, in view of the current COVID-19 pandemic, saliva can be a source of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection 5 for endoscopists and assistants, and this device might be useful for preventing salivary transmission of the virus.

This device has the potential to prevent aspiration pneumonia during upper GI endoscopic procedures, including ERCP. Further clinical studies examining larger samples and randomized controlled trials are needed to assess the incidence of aspiration pneumonia.

Continuous liquid-suction catheter attachment for endoscope reduces volume of liquid reflux to the mouth in esophageal endoscopic submucosal dissection

The incidence of "silent" free air and aspiration pneumonia detected by CT after gastric endoscopic submucosal dissection

Risk factors for pyrexia after endoscopic submucosal dissection of gastric lesions

Usefulness of a continuous suction mouthpiece during percutaneous endoscopic gastrostomy: a single-center, prospective, randomized study

Oral saliva and COVID-19

All authors disclosed no financial relationships.Abbreviation: ESD, endoscopic submucosal dissection.