Hydrogel Antimicrobial Capture Coatings for Endotracheal Tubes: A Pharmaceutical Strategy Designed to Prevent Ventilator-Associated Pneumonia

Jones, David S.; McCoy, Colin; Andrews, Gavin; McCrory, Roisin M.; Gorman, Seán

doi:10.1021/acs.molpharmaceut.5b00208

Cited by 17 publications

(15 citation statements)

References 50 publications

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“…However, both of these additions have proven to be ineffective in preventing the spread of bacteria to the lower trachea and have the potential to damage the trachea (Inglis, Millar, Jones, & Robinson, 1989; Mietto et al, 2013). Additional prevention attempts have included various surface modifications to ETTs such as silver‐coated (Barnes et al, 2019; Olson, Harmon, & Kollef, 2002) and gentamicin‐containing hydrogel‐coated ETTs (Barnes et al, 2019; Jones, McCoy, Andrews, McCrory, & Gorman, 2015). Currently, silver‐coated ETTs are the only commercially approved antimicrobial ETTs in the United States.…”

Section: Introductionmentioning

confidence: 99%

“…Additional prevention attempts have included various surface modifications to ETTs such as silver-coated (Barnes et al, 2019;Olson, Harmon, & Kollef, 2002) and gentamicin-containing hydrogel-coated ETTs (Barnes et al, 2019;Jones, McCoy, Andrews, McCrory, & Gorman, 2015). Currently, silver-coated ETTs are the only commercially approved antimicrobial ETTs in the United States.…”

Section: Introductionmentioning

confidence: 99%

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S‐Nitroso‐N‐acetylpenicillamine impregnated endotracheal tubes for prevention of ventilator‐associated pneumonia

Homeyer

Singha

Goudie

et al. 2020

Biotech & Bioengineering

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The chances of ventilator‐associated pneumonia (VAP) increases 6–20 folds when an endotracheal tube (ETT) is placed in a patient. VAP is one of the most common hospital‐acquired infections and comprises 86% of the nosocomial pneumonia cases. This study introduces the idea of nitric oxide‐releasing ETTs (NORel‐ETTs) fabricated by the incorporation of the nitric oxide (NO) donor S‐nitroso‐N‐acetylpenicillamine (SNAP) into commercially available ETTs via solvent swelling. The impregnation of SNAP provides NO release over a 7‐day period without altering the mechanical properties of the ETT. The NORel‐ETTs successfully reduced the bacterial infection from a commonly found pathogen in VAP, Pseudomonas aeruginosa, by 92.72 ± 0.97% when compared with the control ETTs. Overall, this study presents the incorporation of the active release of a bactericidal agent in ETTs as an efficient strategy to prevent the risk of VAP.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

S‐Nitroso‐N‐acetylpenicillamine impregnated endotracheal tubes for prevention of ventilator‐associated pneumonia

Homeyer

Singha

Goudie

et al. 2020

Biotech & Bioengineering

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“…Concerning hydrophilic polymer materials, poly(2-hydroxyethyl methacrylate) (PHEMA) is one of the most widely used in the manufacture of medical devices, such as contact and intraocular lenses, and medical device coatings [26,27], because it exhibits blood and cell biocompatibility, low cytotoxicity, and thrombogenicity [28,29]. In addition, a variety of antimicrobial agents has been included into hydrogels and materials based on PHEMA to provide biocidal character as an additional property [26,30,31,32]. Herein, we prepared copolymers systems composed of 2-hydroxyethyl methacrylate (HEMA) and a methacrylic monomer bearing thiazolium moieties (MTARI) with the purpose of incorporating antimicrobial properties into PHEMA.…”

Section: Introductionmentioning

confidence: 99%

Providing Antibacterial Activity to Poly(2-Hydroxy Ethyl Methacrylate) by Copolymerization with a Methacrylic Thiazolium Derivative

Muñoz‐Bonilla

López

2018

IJMS

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Antimicrobial polymers and coatings are potent types of materials for fighting microbial infections, and as such, they have attracted increased attention in many fields. Here, a series of antimicrobial copolymers were prepared by radical copolymerization of 2-hydroxyethyl methacrylate (HEMA), which is widely employed in the manufacturing of biomedical devices, and the monomer 2-(4-methylthiazol-5-yl)ethyl methacrylate (MTA), which bears thiazole side groups susceptible to quaternization, to provide a positive charge. The copolymers were further quantitatively quaternized with either methyl or butyl iodide, as demonstrated by nuclear magnetic resonance (NMR) and attenuated total reflection Fourier-transform infrared spectroscopy (ATR-FTIR). Then, the polycations were characterized by zeta potential measurements to evaluate their effective charge and by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA) to evaluate their thermal properties. The ζ-potential study revealed that the quaternized copolymers with intermediate compositions present higher charges than the corresponding homopolymers. The cationic copolymers showed greater glass transition temperatures than poly(2-hydroxyethyl methacrylate) (PHEMA), with values higher than 100 °C, in particular those quaternized with methyl iodide. The TGA studies showed that the thermal stability of polycations varies with the composition, improving as the content of HEMA in the copolymer increases. Microbial assays targeting Gram-positive and Gram-negative bacteria confirmed that the incorporation of a low number of cationic units into PHEMA provides antimicrobial character with a minimum inhibitory concentration (MIC) of 128 µg mL−1. Remarkably, copolymers with MTA molar fractions higher than 0.50 exhibited MIC values as low as 8 µg mL−1.

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“…To conquer these limitations, a reasonable option is to use a sustained drug release technique to locally deliver anesthetic agent, which allows for an extended effective duration, a higher local drug concentration, and lower adverse effects. Recent studies showed that the sustained release of corticosteroids or antimicrobials from surface coatings, including electrospinning, hydrogel, and dip coatings, on endotracheal tubes (ETTs) is feasible and effective in reducing inflammatory reactions and preventing ventilator-related infection (16)(17)(18). Therefore, surface coating techniques may also be applicable to local LDC delivery for enhancing the local anesthetic effect.…”

Section: Introductionmentioning

confidence: 99%

“…Compared to other reported ETT coating techniques, the evaporation of spray coating is faster, which reduces the impact on the substrate from dip coatings where the tube needs to be immersed in solvent (18), and can easily prepare a thin, uniform, and transparent coating. At the same time, hydrogel (17) and electrospinning (16) ETT coatings are thicker (0.17-0.2 mm), which may limit their application in small diameter ETTs, such as size 2.5: inner diameter =2.5 mm, and outer diameter =3.3 mm.…”

Section: Introductionmentioning

confidence: 99%

Lidocaine-eluting endotracheal tube effectively attenuates intubation related airway response

Lu¹,

Tian²,

Cui³

et al. 2021

Ann Transl Med

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Background: Lidocaine (LDC) is a local anesthetic widely used to relieve intubation-related airway responses. However, low drug concentration and short effective duration of LDC is inadequate to provide a satisfactory anesthetic effect on the surface of the airway. The present study sought to develop a LDCdelivery endotracheal tube (ETT) to achieve high local drug concentration and sustained drug release with the aim of attenuating an intubation-related airway response.Methods: ETTs and polyvinyl chloride (PVC) discs were coated with different molecular weight (MW) poly lactic-co-glycolic acid (PLGA: 50/50; MW: 3,000, 6,000, and 10,000) loaded with LDC by airbrush spray. The morphology of LDC-eluting coatings was analyzed using scanning electron microscopy. In vitro drug release was determined by ultraviolet spectrophotometer. An in vivo study was performed to investigate the differences in plasma LDC concentration, intubation tolerance, and tracheal tissue injury in rabbits undergoing intubation of blank, LDC-spray, or LDC-coated ETTs.Results: Approximate 5 mg/cm 2 coatings (containing 2.5 mg/cm 2 LDC) were deposited onto the PVC discs and ETTs. While even distribution and smooth surfaces were generated in PLGA3000 + LDC and PLGA6000 + LDC coatings, PLGA10000 + LDC formed uneven and gullied coatings. Burst release within the first 4 h and sustained release for at least 5 days was achieved in vitro in PLGA + LDC coatings and the in vivo study demonstrated higher plasma LDC concentration and longer drug release duration in LDC-coated ETTs compared with LDC-spray. LDC-coated ETTs significantly improved intubation tolerance in rabbits, as measured by less general anesthetic consumption and longer tube tolerance duration in contrast to blank ETTs with or without LDC spray. Histology assessment showed less mucosal edema area in the PLGA3000 + LDC and PLGA6000 + LDC groups compared to the control, LDC-spray, and PLGA10000 + LDC groups. Among the different MW PLGAs, PLGA6000 presented optimal morphological characteristics, drug release, and anesthetic effect.Conclusions: ETTs coated with PLGA + LDC effectively attenuate an intubation-related airway response

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Hydrogel Antimicrobial Capture Coatings for Endotracheal Tubes: A Pharmaceutical Strategy Designed to Prevent Ventilator-Associated Pneumonia

Abstract: (2015). Hydrogel antimicrobial capture coatings for endotracheal tubes; a pharmaceutical strategy designed to prevent ventilator-associated pneumonia.

Cited by 17 publications

References 50 publications

S‐Nitroso‐N‐acetylpenicillamine impregnated endotracheal tubes for prevention of ventilator‐associated pneumonia

S‐Nitroso‐N‐acetylpenicillamine impregnated endotracheal tubes for prevention of ventilator‐associated pneumonia

Providing Antibacterial Activity to Poly(2-Hydroxy Ethyl Methacrylate) by Copolymerization with a Methacrylic Thiazolium Derivative

Lidocaine-eluting endotracheal tube effectively attenuates intubation related airway response

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