Impact of a Low-Pressure Polyurethane Adult Endotracheal Tube on the Incidence of Ventilator-Associated Pneumonia: A before and after Concurrence Study

Abstract

Background. Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care unit (ICU) patients, encompassing up to 15% of all hospital acquired infections. Our hospital implemented a facility-wide conversion from a low-volume high-pressure polyvinyl cuffed endotracheal tube (PV-cuffed ETT) to a high-volume low-pressure (HVLP) polyurethane-cuffed endotracheal tube (PU-cuffed ETT) in an effort to reduce the incidence of VAP. Methods. We completed an IRB approved, retrospective chart review comparing the number of episodes of VAP 12 months preceding and following the introduction of a new ETT. A diagnosis of VAP was made based upon the guidelines of our institution, consistent with the Center of Disease Control and Prevention definition. Results. The number of patients developing VAP the year after the ETT conversion reduced to 32 (16.3%) from 68 (24.7%) the year before the conversion ( = 0.028). The rate of VAP was reduced by 56% per ventilator day after the implementation of the PU-cuffed ETT ( < 0.001). No significant differences were observed in length of hospital stay, length of mechanical ventilation, or mortality before or after the conversion. Conclusions. We found that HVLP PU-cuffed ETTs were associated with a statistically significant reduction of VAP in the adult ICUs.

Polyurethane cuffed versus conventional endotracheal tubes: Effect on ventilator-associated pneumonia rates and length of Intensive Care Unit stay

“…A significant reduction in the median ICU stay was found in patients intubated with PU-cuffed tubes when compared to patients who were on conventional cuffed tubes (17–11 days). [ 10 ] The presence of hospital-acquired pneumonia (HAP) is known to increase hospital stay by 7–9 days. The incidence of HAP is noted to be 20 times higher in patients who are mechanically ventilated.…”

Bacterial Identification And Antibiotics Sensitivity Of Ventilator-Associated Pneumonia (VAP) Patients At RSD Dr. Soebandi Jember

“…Gadani's research showed that 37% of patients hospitalized in the Intensive Care Unit (ICU) became VAP (Gadani et al, 2010). Prolonged use of a ventilator leads to VAP risk, thereby increasing mortality from 5% to 65% (Schweiger et al, 2013) Several factors that influence VAP include the patient's age, length of use of a ventilator, patient consciousness level, comorbid disease, and antibiotic treatment (Wu et al, 2019) Several studies have reported bacterial resistance to antibiotics in humans, animals, and the environment García et al,2020;Hoque et al, 2020). The negative impact of bacterial resistance in humans is that the infection does not recover by antibiotic therapy, more complication, a longer length of stay, higher cost of care, and increased patient mortality rate (Collignon, 2012;(Friedman et al, 2016).…”

Efficacy of Noble Metal–alloy Endotracheal Tubes in Ventilator-associated Pneumonia Prevention: a Randomized Clinical Trial

“…A previous study reported a shorter ICU stay in patients using PU-cuffed tubes than in patients who used conventional cuffed tubes (17–11 days). 21 Previous studies have suggested that silver-coated ETTs were associated with reduced mortality in patients who developed VAP; however, studies using noble metal–alloy ETTs are limited.…”