Above and beyond: biofilm and the ongoing search for strategies to reduce ventilator-associated pneumonia (VAP)

Excerpt

We read with great interest the article by Thorarinsdottir et al. [1] that compared biofilm formation on three endotracheal tube (ETT) types with the finding that biofilm formation was reduced in silicone and noble-metal coated ETTs compared to uncoated ETTs. Their findings have significant implications during the current pandemic given the prolonged intubation times of COVID-19 patients and many develop superimposed pneumonias during their hospital course. It is intriguing that simply changing the ETT’s coating may have significant implications in this patient population with already limited pulmonary reserve that is unable to tolerate additional insults to their lung from a ventilator-associated pneumonia (VAP). However, given the prolonged intubation times of COVID-19 patients, it is likely that the ETT biofilm burden will be substantial no matter which surface coating is utilized. Here, we discuss other strategies to reduce the incidence of VAP. …