Internally coated endotracheal tubes with silver sulfadiazine in polyurethane to prevent bacterial colonization: A clinical trial
Stelfox, Henry T.
Bigatello, Luca M.
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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 16h).
Berra L, Kolobow T, Laquerriere P, Pitts B, Bramati S, Pohlmann J, Marelli C, Panzeri M, Brambillasca P, Villa F, Baccarelli A, Bouthors S, H.T. Stelfox HT, Bigatello LM, Moss J, Pesenti A, "Internally coated endotracheal tubes with silver sulfadiazine in polyurethane to prevent bacterial colonization: A clinical trial," Intensive Care Med. 2008 34(6):1030-1037