Antibacterial-coated tracheal tubes cleaned with the Mucus Shaver : A novel method to retain long-term bactericidal activity of coated tracheal tubes.
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[Symbol: see text]h. The ETT was suctioned every 6[Symbol: see text]h. Study group: Six sheep were intubated and mechanically ventilated for 72[Symbol: see text]h. The ETT was suctioned and cleaned with the MS every 6[Symbol: see text]h. An additional sheep was intubated and mechanically ventilated for 168[Symbol: see text]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[Symbol: see text]mum, range 270-550[Symbol: see text]mum. 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[Symbol: see text]h of mechanical ventilation.