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Published in: Intensive Care Medicine 6/2006

01-06-2006 | Experimental

Antibacterial-coated tracheal tubes cleaned with the Mucus Shaver

A novel method to retain long-term bactericidal activity of coated tracheal tubes

Authors: Lorenzo Berra, Francesco Curto, Gianluigi Li Bassi, Patrice Laquerriere, Andrea Baccarelli, Theodor Kolobow

Published in: Intensive Care Medicine | Issue 6/2006

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Abstract

Objective

To assess the long-term benefit from antibacterial coatings of the tracheal tube (ETT), and to keep clean the lumen of the ETT.

Design

Experimental animal study.

Setting

USA National Institutes of Health.

Subjects

Twelve sheep.

Interventions

Twelve ETTs were internally dip-coated with a silver-sulfadiazine in polyurethane. We developed a concentric inflatable silicone rubber “razor”, the Mucus Shaver (MS), to shave the ETT lumen free of mucus. In a single pass, we cleaned all mucus from the internal surface of the ETT.
Control group: Five intubated sheep were mechanically ventilated for 72 h. The ETT was suctioned every 6 h.
Study group: Six sheep were intubated and mechanically ventilated for 72 h. The ETT was suctioned and cleaned with the MS every 6 h. An additional sheep was intubated and mechanically ventilated for 168 h.
Bacteriologic studies and scanning electron microscopy were performed to assess bacterial colonization and thickness of secretions on the internal surface of the ETT.

Measurements and main results

In the control group, the ETT was always heavily colonized: median debris thickness was 380 μm, range 270–550 μm. In the study group, there was no colonization and no secretions in the ETT, except for three ETT that were colonized solely at the very tip.

Conclusions

Silver-based coating of ETT cleaned with the MS every 6 h significantly reduces accumulation of mucus/secretion and bacterial growth within the ETT following 72 h of mechanical ventilation.
Appendix
Available only for authorised users
Footnotes
1
Patent applied for by National Institutes of Health
 
Literature
1.
go back to reference Adair CG, Gorman SP, Feron BM, Byers LM, Jones DS, Goldsmith CE, Moore JE, Kerr JR, Curran MD, Hogg G, Webb CH, McCarthy GJ, Milligan KR (1999) Implications of endotracheal tube biofilm for ventilator-associated pneumonia. Intensive Care Med 25:1072–1076CrossRefPubMed Adair CG, Gorman SP, Feron BM, Byers LM, Jones DS, Goldsmith CE, Moore JE, Kerr JR, Curran MD, Hogg G, Webb CH, McCarthy GJ, Milligan KR (1999) Implications of endotracheal tube biofilm for ventilator-associated pneumonia. Intensive Care Med 25:1072–1076CrossRefPubMed
2.
go back to reference Inglis TJ, Millar MR, Jones JG, Robinson DA (1989) Tracheal tube biofilm as a source of bacterial colonization of the lung. Clin Microbiol 27:2014–2018 Inglis TJ, Millar MR, Jones JG, Robinson DA (1989) Tracheal tube biofilm as a source of bacterial colonization of the lung. Clin Microbiol 27:2014–2018
3.
go back to reference Shapiro M, Wilson RK, Casar G, Bloom K, Teague RB (1986) Work of breathing through different sized endotracheal tubes. Crit Care Med 14:1028–1031PubMedCrossRef Shapiro M, Wilson RK, Casar G, Bloom K, Teague RB (1986) Work of breathing through different sized endotracheal tubes. Crit Care Med 14:1028–1031PubMedCrossRef
4.
go back to reference Heyer L, Louis B, Isabey D, Lofaso F, Brochard L, Fredberg JJ, Harf A (1996) Noninvasive estimate of work of breathing due to the endotracheal tube. Anesthesiology 85:1324–1333CrossRefPubMed Heyer L, Louis B, Isabey D, Lofaso F, Brochard L, Fredberg JJ, Harf A (1996) Noninvasive estimate of work of breathing due to the endotracheal tube. Anesthesiology 85:1324–1333CrossRefPubMed
5.
go back to reference Glass C, Grap MJ, Sessler CN (1999) Endotracheal tube narrowing after closed-system suctioning: prevalence and risk factors. Am J Crit Care 8:93–100PubMed Glass C, Grap MJ, Sessler CN (1999) Endotracheal tube narrowing after closed-system suctioning: prevalence and risk factors. Am J Crit Care 8:93–100PubMed
6.
go back to reference Shah C, Kollef MH (2004) Endotracheal tube intraluminal volume loss among mechanically ventilated patients. Crit Care Med 32:120–125CrossRefPubMed Shah C, Kollef MH (2004) Endotracheal tube intraluminal volume loss among mechanically ventilated patients. Crit Care Med 32:120–125CrossRefPubMed
7.
go back to reference Boque MC, Gualis B, Sandiumenge A, Rello J (2004) Endotracheal tube intraluminal diameter narrowing after mechanical ventilation: use of acoustic reflectometry. Intensive Care Med 30:2204–2209CrossRefPubMed Boque MC, Gualis B, Sandiumenge A, Rello J (2004) Endotracheal tube intraluminal diameter narrowing after mechanical ventilation: use of acoustic reflectometry. Intensive Care Med 30:2204–2209CrossRefPubMed
8.
go back to reference Berra L, De Marchi L, Yu ZX, Laquerriere P, Baccarelli A, Kolobow T (2004) Endotracheal tubes coated with antiseptics decrease bacterial colonization of the ventilator circuits, lungs, and endotracheal tube. Anesthesiology 100:1446–1456PubMedCrossRef Berra L, De Marchi L, Yu ZX, Laquerriere P, Baccarelli A, Kolobow T (2004) Endotracheal tubes coated with antiseptics decrease bacterial colonization of the ventilator circuits, lungs, and endotracheal tube. Anesthesiology 100:1446–1456PubMedCrossRef
9.
go back to reference Olson ME, Harmon BG, Kollef MH (2002) Silver-coated endotracheal tubes associated with reduced bacterial burden in the lungs of mechanically ventilated dogs. Chest 1:863–870CrossRef Olson ME, Harmon BG, Kollef MH (2002) Silver-coated endotracheal tubes associated with reduced bacterial burden in the lungs of mechanically ventilated dogs. Chest 1:863–870CrossRef
10.
go back to reference Kolobow T, Berra L, Li Bassi G, Curto F (2005) A novel system for the complete removal of all secretions from within the tracheal tube: “The Mucus Shaver”. Anesthesiology 102:1063–1065CrossRefPubMed Kolobow T, Berra L, Li Bassi G, Curto F (2005) A novel system for the complete removal of all secretions from within the tracheal tube: “The Mucus Shaver”. Anesthesiology 102:1063–1065CrossRefPubMed
11.
go back to reference Guide for the care and use of laboratory animals (1996) Washington D.C., National Academy Press, pp 1–80 Guide for the care and use of laboratory animals (1996) Washington D.C., National Academy Press, pp 1–80
12.
go back to reference Panigada M, Berra L, Greco G, Stylianou M, Kolobow T (2003) Bacterial colonization of the respiratory tract following tracheal intubation-effect of gravity: an experimental study. Crit Care Med 31: 729–737 Panigada M, Berra L, Greco G, Stylianou M, Kolobow T (2003) Bacterial colonization of the respiratory tract following tracheal intubation-effect of gravity: an experimental study. Crit Care Med 31: 729–737
13.
go back to reference Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report, CDC/MMWR: Guidelines for Prevention of Nosocomial Pneumonia. January 03, 1997 / 46(RR-1);1–79. Available on line at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00045365.htm Accessed January 8, 2004 Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report, CDC/MMWR: Guidelines for Prevention of Nosocomial Pneumonia. January 03, 1997 / 46(RR-1);1–79. Available on line at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00045365.htm Accessed January 8, 2004
14.
go back to reference Pacheco-Fowler V, Gaonkar T, Wyer PC, Modak S. (2004) Antiseptic impregnated endotracheal tubes for the prevention of bacterial colonization. J Hosp Infect 57:170–174CrossRefPubMed Pacheco-Fowler V, Gaonkar T, Wyer PC, Modak S. (2004) Antiseptic impregnated endotracheal tubes for the prevention of bacterial colonization. J Hosp Infect 57:170–174CrossRefPubMed
15.
go back to reference Girou E, Buu-Hoi A, Stephan F, Novara A, Gutmann L, Safar M, Fagon JY (2004) Airway colonization in long-term mechanically ventilated patients Effect of semi-recumbent position and continuous subglottic suctioning. Intensive Care Med 30:225–233PubMedCrossRef Girou E, Buu-Hoi A, Stephan F, Novara A, Gutmann L, Safar M, Fagon JY (2004) Airway colonization in long-term mechanically ventilated patients Effect of semi-recumbent position and continuous subglottic suctioning. Intensive Care Med 30:225–233PubMedCrossRef
Metadata
Title
Antibacterial-coated tracheal tubes cleaned with the Mucus Shaver
A novel method to retain long-term bactericidal activity of coated tracheal tubes
Authors
Lorenzo Berra
Francesco Curto
Gianluigi Li Bassi
Patrice Laquerriere
Andrea Baccarelli
Theodor Kolobow
Publication date
01-06-2006
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 6/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-006-0125-6

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