Airway Secretions in Mechanically Ventilated Patients: Observations and Gaps

Overview

The study introduces the Respiratory Secretion Scale (RESES), a standardized tool for categorizing airway secretions in mechanically ventilated patients. Validation of RESES showed excellent agreement in classifying secretion type and amount.

Background

Airway secretions in mechanically ventilated patients are often assessed subjectively, leading to inconsistencies that can impact clinical decisions. Standardized measurement tools are necessary to improve the management of airway secretions.

Data Highlights

No numerical data or trial data presented in the source material.

Key Findings

• The Respiratory Secretion Scale (RESES) categorizes secretions into 7 types and 3 amounts.
• Validation of RESES showed excellent agreement for secretion type, amount, and combined classification.
• Nonsurvivors more frequently had purulent or bloody-mucoid secretions.
• Large secretion amounts correlated with respiratory disease, pulmonary infection, and prolonged mechanical ventilation.
• Secretion amount was associated with consolidation on chest imaging.
• Weak cough and endotracheal secretions predicted extubation failure.

Clinical Implications

The implementation of standardized tools like RESES can enhance the consistency of secretion assessments in mechanically ventilated patients.

Conclusion

Standardizing the measurement of airway secretions is essential for improving assessments in mechanically ventilated individuals.

Related Resources & Content

1. Ferrari et al, Respiratory Care, 2026 -- Development and Validation of the Respiratory Secretion Scale (RESES) in Mechanically Ventilated Patients
2. Intensive Care Medicine — Assessing the Need for Enhanced Evidence or Broader Perspectives in VAP Prevention
3. Frontiers in Medicine — Impact of closed-system suctioning on self-reported dyspnea in mechanically ventilated patients: a prospective observational study
4. Intensive Care Medicine — Highlights from Intensive Care Medicine in 2014: Focus on ARDS, Airway Management, Ventilation Strategies, Sepsis Adjuvants, Hepatic Failure, Symptom Evaluation and Treatment, Palliative Care for Families, Prognostic Factors, Organ Donation, Patient Outcomes, Healthcare Organization, and Research Approaches
5. Intensive Care Medicine — Highlights from Intensive Care Medicine 2012: Focus on Noninvasive Ventilation, Patient Monitoring, Ventilator Interactions, Acute Respiratory Distress Syndrome, Sedation Practices, Pediatric Considerations, and Additional Topics
6. Ventilator-associated Event (VAE)
7. Expert consensus–based clinical practice guidelines for Care and weaning procedures in tracheostomized ICU patients
8. The efficacy of subglottic secretion drainage in preventing ventilator-associated pneumonia in the intensive care unit: a systematic review and meta-analysis
9. Physiological and clinical effects of selected airway clearance techniques in mechanically ventilated adult ICU patients: a systematic review and synthesis without meta-analysis - PubMed
10. Airway tracers and biomarkers for aspiration detection and VAP prediction in ICU patients with tracheal tubes: a systematic review and diagnostic accuracy meta-analysis - ScienceDirect
11. Development and Validation of the Respiratory Secretion Scale (RESES) in Mechanically Ventilated Patients - Gabriela Ferrari, Jéssica Magnante, Laura Maito Mantelli, Alana Cristina Gonçalves, Rafhaela Mocelin, Polyana Karla Belotto, Roberta Fleck Bazzo, Gustavo Bruno Rático, Silvano Altair do Nascimento, Wan Cley Rabuske, Luis Felipe da Fonseca Reis, Diego de Carvalho, Antuani Rafael Baptistella, 2026