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Investigating the Failure to Aspirate Subglottic. Internationa; Anesthsia Research Society, 1083 – 1085.
By Dragoumanis, C. K., Vretzakis, G. I., Papaioannou, V. E., Didilis, V. N., Vogiatzaki, T. D., & Pneumatikos, I. A., 2007

There have been many cases in the medical case study in which the subglottic secretions were used for preventing pneumonia as mentioned in the article provided. This has resulted in development of dysfunction of many parts in the respiratory track like the suction lumen (Dezfulian, et al., 2005).
Type of study
In the article, Cohort type of study has been utilized which refers to one form of research and study that would involve analysis of various factors carried among a group of people, consisting of 40 adult patients. These participants have been treated with Evac ETT. It has been carried out on people who share a common characteristic of medical condition and its treatment. It is a prospective cohort type of study as it has classified the patients in the form of participants who have been provided with Evac ETT. The effects of the treatment on these participants are developed (Deem & Treggiari, 2010).
Overall quality of the report
The research has got approval from the Institutional Scientific Board. The report has been developed after an intubation of Evac ETT in men and women. On the basis of this, the effect of this insertion led to the dysfunction suction lumen and damage of the tracheal mucosa which contains the subglottic suction port.
Robustness of the study
The robustness of the study has been developed through critically appraisal using critical appraisal tools like CASP. It involves developing of certain questions and parameters in the form of a checklists. These checklists may contain the following elements (Fowler, 2001):
1. Are the results obtained from the study valid?
Yes, the results obtained are valid as it has been carried over the patients who have been treated with Evac ETT. The results provide that about 48% of the participants had faced dysfunction in their suction lumen. In 43% of the participants, it was found that there was obstruction of the subglottic suction due to the blockage in the tracheal mucosa.
2. Did the study address the issue with precise focus and without any bias?
The issue of safety in using the Evac ETT technique for the suction of the subglottic port has been very well addressed and directly obtained in the study. It also establishes the effects on the tracheal mucosa due to the insertion.
Criticisms of the study
Critical analysis of the article have been displayed using two factors which have helped in developing robustness of the study. The critical evaluation of the method used involves considering the effects that the selected method has on the health of the patients. This makes the study very complex to practice and execute (Denzin & Lincoln, 2009). The patients who were taken into consideration as the participants were provided intubation of Evac ETT. Then they were placed in different positions, at different angles to determine the effects on the trachea and their responses at the end of 30 and 60 minutes were taken. This shows how effective the study is considering the detailed structure of the research that has been carried out on the patients for development of their subglottic secretion and dysfunction in their suction lumen. Thus, the critical analysis favors the method used in the report.

References
Deem, S., & Treggiari, M. M. (2010). New endotracheal tubes designed to prevent ventilator-associated pneumonia: do they make a difference? Respiratory care, 55(8), , 1046-1055.
Denzin, N. K., & Lincoln, Y. S. (2009). Qualitative research. . Yogyakarta: PustakaPelajar.
Dezfulian, C., Shojania, K., Collard, H. R., Kim, H. M., Matthay, M. A., & Saint, S. (2005). Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis. The American journal of medicine, 118(1), , 11-18.
Dragoumanis, C. K., Vretzakis, G. I., Papaioannou, V. E., Didilis, V. N., Vogiatzaki, T. D., & Pneumatikos, I. A. (2007). Investigating the Failure to Aspirate Subglottic. Internationa; Anesthsia Research Society, 1083 – 1085.
Fowler, G. R. (2001). Evidence-based practice: Tools and techniques. . Systems, settings, people: Workforce development challenges for the alcohol and other drugs field,, 93-107.