Internally coated endotracheal tubes with silver sulfadiazine in polyurethane to prevent bacterial colonization: a clinical trial

Autor: Joshua R. Pohlmann, Sylvie Bouthors, Antonio Pesenti, Miriam Fiore Panzeri, Andrea A. Baccarelli, Simone Bramati, Henry T. Stelfox, Joel Moss, Theodor Kolobow, Patrice Laquerriere, Chiara Marelli, Betsey Pitts, Luca M. Bigatello, Lorenzo Berra, F. Villa, Pietro Brambillasca
Přispěvatelé: Berra, L, Kolobow, T, Laquerriere, P, Pitts, B, Bramati, S, Pohlmann, J, Marelli, C, Panzeri, M, Brambillasca, P, Villa, F, Baccarelli, A, Bouthors, S, Stelfox, H, Bigatello, L, Moss, J, Pesenti, A
Rok vydání: 2008
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
Polyurethanes
Colony Count
Microbial
Lumen (anatomy)
Critical Care and Intensive Care Medicine
Silver sulfadiazine
Statistics
Nonparametric
law.invention
Sulfadiazine
Coated Materials
Biocompatible
endotracheal tube
mechanical ventilation
bacterial biofilm
ventilator-associated pneumonia
silver sulfadiazine
law
Intensive care
Intubation
Intratracheal
Settore MED/44 - Medicina del Lavoro
Humans
Medicine
Intubation
Colonization
Prospective Studies
MED/41 - ANESTESIOLOGIA
Aged
Microscopy
Confocal
Ventilators
Mechanical
business.industry
endotracheal tubes
silver sulfadiazine
polyurethane
bacterial colonization
Ventilator-associated pneumonia
Pneumonia
Ventilator-Associated
medicine.disease
Silver Sulfadiazine
Intensive care unit
Surgery
Microscopy
Electron
Scanning
Equipment Contamination
Female
business
Disinfectants
medicine.drug
Zdroj: Intensive Care Medicine. 34
ISSN: 1432-1238
0342-4642
DOI: 10.1007/s00134-008-1100-1
Popis: Objective: Coated medical devices have been shown to reduce catheter-related infections. We coated endotracheal tubes (ETT) with silver sulfadiazine (SSD), and tested them in a clinical study to assess the feasibility, safety, and efficacy of preventing bacterial colonization. Design: A prospective, randomized clinical trial, phase I-II. Setting: Academic intensive care unit (ICU). Participants: Forty-six adult patients expected to need 12-24 h of intubation were randomized into two groups. Interventions: Patients were randomized to be intubated with a standard non-coated ETT (St-ETT, n = 23; control group), or with a SSD-coated ETT (SSD-ETT, n = 23). Measurements and results: Coating with SSD prevented bacterial colonization of the ETT (frequency of colonization: SSD-ETT 0/23, St-ETT 8/23; p < 0.01). No organized bacterial biofilm could be identified on the lumen of any ETT; however, SSD was associated with a thinner mucus layer (in the SSD-ETT secretion deposits ranged from 0 to 200 μm; in the St-ETT deposits ranged between 50 and 700 μm). No difference was observed between the two groups in the tracheobronchial brush samples (frequency of colonization: SSD-ETT 0/23, St-ETT 2/23; p = 0.48). No adverse reactions were observed with the implementation of the novel device. Conclusion: SSD-ETT can be safely used in preventing bacterial colonization and narrowing of the ETT in patients intubated for up to 24 h (mean intubation time 16 h). © 2008 Springer-Verlag.
Databáze: OpenAIRE
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