Cleaning the endotracheal tube with a specifically designed device results in lower amount of secretions at extubation, assessed by micro CT scan

Inclusion Criteria:

• Patients admitted to an ICU
• 18 years old or more
• expected to be intubated for more than 48 hours
• less than 24 hours from intubation
• fraction of inspired oxygen set at the ventilator <80%

Exclusion Criteria:

• Current or past participation in another intervention trial conflicting with the present study
• expected survival less than 24 hours
• Acute severe asthma
• Use of Extracorporeal membrane oxygenation (ECMO) or candidates for ECMO
• Double lumen endotracheal tube in place
• Conditions which pose the patient at high risk if inadvertent endotracheal tube displacement occurs (laryngeal edema, cervical spine trauma, upper airways diseases with difficult reintubation)
• other contraindications posed by staff physicians