Skip to main content Accessibility help
×
×
Home

Reduced Resistance to Air Flow from Nanomodified Endotracheal Tubes

  • Mary C. Machado (a1), Keiko M. Tarquinio (a2) and Thomas J. Webster (a3)

Abstract

Ventilator associated pneumonia (VAP) is a serious and costly clinical problem. Specifically, receiving mechanical ventilation over 24 hours increases the risk of VAP and is associated with high morbidity, mortality and medical costs. Cost effective endotracheal tubes (ETTs) that are resistant to bacterial infection would help to prevent this problem. The objective of this study was to determine differences in bacterial growth on nanomodified and unmodified ETTs under dynamic airway conditions, a bench top model based upon the general design of Hartmann et al. (1999) was constructed to test of the effectiveness of nanomodified ETTs under the airflow conditions present in the airway. Twenty-four hour studies performed in a dynamic flow chamber showed a marked difference in the biofilm formation on different areas of unmodified tubes. Areas where tubes were curved, such as at the entrance to the mouth and the connection between the oropharynx and the larynx, seemed to collect the largest amount of biofilm. On the nanomodified tubes biofilm formation was markedly different occurring on smaller pieces.

The biofilm formation on ETTs in the airflow system after 24 hours showed a large difference depending upon where tubes were oriented within the apparatus. This illustrates the importance of dynamic flow on biofilm formation in pediatric ETTs. It is of particular interest that increased biofilm density on both unmodified and nanomodified tubes appeared to occur at curves in the tube where changes in flow pattern occured. This emphasizes the need for more accurate models of airflow within pediatric ETTs, suggesting that not only does flow affect pressure gradients along the tube, but in fact, determines the composition of the film itself. More testing is needed to determine the effects of biofilm formation on the efficiency of ETT under airflow, however this study provides significant evidence for nanomodification alone (without the use of antibiotics) to decrease bacteria function.

Copyright

References

Hide All
1. Office of Quality and Performance, FY 2008, Q1 technical manual for the VHA performance measurement system, 315 (2007).
2. Bahrani-Mougeot, F. K., Paster, B. J. and Coleman, S., “Molecular analysis of oral and respiratory bacterial species associated with ventilator-associated pneumonia.” J Clin Microbiology 45, 1588–1593 (2007).
3. Marini, J. J. and Slutsky, A. S., Physiological basis of ventilatory support. New York: Marcel Dekker (1998).
4. Cardinal, P., Jessamine, P., Carter-Snell, C., Morrison, S., and Jones, G., “Contribution of water condensation in endotracheal tubes to contamination of the lungs.” Chest, 127–129 (1993).
5. Hartmann, M., Guttmann, J., Muller, B., Hallmann, T., and Geiger, K., “Reduction of the bacterial load by the silver-coated endotracheal tube (SCET) a laboratory investigation.” Technology and Health Care, 359–70 (1999).
6. Guttmann, J, Eberhard, L, Fabry, B, Bertschmann, W, Wolff, G. “Continuous calculation of intratracheal pressure in tracheally intubated patients.” Anesthesiology 79, 503–13 (1993)
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

MRS Online Proceedings Library (OPL)
  • ISSN: -
  • EISSN: 1946-4274
  • URL: /core/journals/mrs-online-proceedings-library-archive
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed