Endotracheal suctioning is an important component of tracheobronchial hygiene therapy in mechanically ventilated patients. In the perioperative settings, the aspiration of pulmonary secretions from a patient with an artificial airway is carried out with a suction catheter using an open system. Suctioning an intubated patient with coronavirus disease 2019 (COVID-19) is an aerosol-generating procedure and is therefore at high risk of spreading infection.2,3  Although the clinicians performing the suctioning of tracheal secretions are equipped with level III protection; a closed-suction system is desirable and likely adds extra protection. However, a closed system for tracheal suction is often not provided in an operating room and its availability is extremely limited in the pandemic era. Therefore, we created a closed-suction system functionally comparable with that routinely used in the critical care unit...

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