Hospital and long-term outcomes for subglottic suction and polyurethane cuff versus standard endotracheal tubes in emergency intubation (PreVent 2): a randomised controlled phase 2 trial

Treggiari, MM; Sharp, ES; Ohnuma, T; Fajardo, EC; Aydin, A; Akhtar, S; Kampp, M; Hashemaghaie, M; Potnis, A; Gugel, T; Simon, J; Curry, LG; Adams, K; Darji, B; Sureshanand, S; Hintz, R; Lorzano, SN; Johnson, C; Yanez, ND

doi:10.1016/s2213-2600(25)00294-2

Airway management

Hospital and long-term outcomes for subglottic suction and polyurethane cuff versus standard endotracheal tubes in emergency intubation (PreVent 2): a randomised controlled phase 2 trial

Lancet Respir MedPublished 27 Nov 2025Randomised controlled trial

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Authors' conclusion

At 6-month follow-up, neither quality of life, cognitive function, nor laryngeal injury differed between groups.

Study context

Population: Adults requiring emergency endotracheal intubation in the ED or elsewhere in hospital for acute respiratory distress or failure (OHSU and YNHH, USA)157 completed 6-month visit
Participants: 1,068 adults

Comparison: PU-EVAC vs PVC
PU-EVACn = 535
PVCn = 533reference
Primary endpoint: Coprimary: laryngeal injury, quality of life (SF-36 PCS and MCS), cognitive function
Follow-up: 6 months

Methodological detailsphase 2, two centres, 1:1 randomisation

Phase 2
Two centres
1:1 randomisation

Primary result

As reported in the abstract

Coprimary endpoints

PU-EVAC83%71

PVC70%49

PU-EVAC vs PVCEstimate (95% CI)P value

Laryngeal injury

risk difference 0.11(−0.03 to 0.20)

P = 0.098

PCS

mean difference −0.52(−4.21 to 3.17)

P = 0.78

MCS

mean difference −2.98(−7.03 to 1.07)

P = 0.15

Cognitive impairment

risk difference 0.05(−0.07 to 0.17)

P = 0.44

Secondary outcomes

Outcome	PU-EVAC	PVC	← Lower with PU-EVAC ←→ Higher with PU-EVAC →	Risk difference
Infection-related ventilator-associated complications (IVAC)	8%	6%	−0.04−0.0200.020.040.06	0.02 (95% CI −0.01 to 0.05)
Possible VAP	6%	5%	−0.04−0.0200.020.040.06	0.01 (CI −0.02 to 0.04)
			−0.04−0.0200.020.040.06Difference (linear scale)

Death · 6 months

PU-EVAC51%

PVC53%

Death: 558 died in total

Original publication

Hospital and long-term outcomes for subglottic suction and polyurethane cuff versus standard endotracheal tubes in emergency intubation (PreVent 2): a randomised controlled phase 2 trial. Lancet Respir Med. Published 27 November 2025. doi:10.1016/s2213-2600(25)00294-2

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