Zanella A, et al. - Via in vitro analyses, researchers evaluated the performance of a novel prototype device conceived by them that automatically eliminates fluids collected below the endotracheal tube (ETT) cuff, when synchronized with the ventilator, and avoids endotracheal suctioning. In cough flow study, they assessed the capability of the device to generate an effective artificial cough flow (artificial cough maneuver) > 1 L/s by rapidly deflating the ETT cuff within the time of a sustained inflation (at 30 and at 40 cm H₂O) and found an effective artificial cough maneuver was offered by the prototype, with a mean ± SD of 1.78 ± 0.19 L/s (range, 1.42–2.14 L/s). In fluid removal study, the device's ability to remove the fluid positioned below the ETT cuff using saline dye was tested and it was found that the prototype removed the fluid from below the ETT cuff and the experimental trachea. Via aspiration study, they tested its efficacy in preventing the aspiration of saline dye from above the ETT cuff during the deflation phase of the ETT cuff and found that no fluid was aspirated from the area above the ETT cuff toward the lower airways. The use of endotracheal suctioning and its complications may be decreased by using this system.