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Intensive Care Med. 2008 Jun;34(6):1030-7. doi: 10.1007/s00134-008-1100-1. Epub 2008 Apr 17.

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

Author information

1
Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. lberra@partners.org

Abstract

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 microm; in the St-ETT deposits ranged between 50 and 700 microm). 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).

PMID:
18418571
DOI:
10.1007/s00134-008-1100-1
[Indexed for MEDLINE]

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