Erschienen in:
01.06.2008 | Original
Internally coated endotracheal tubes with silver sulfadiazine in polyurethane to prevent bacterial colonization: a clinical trial
verfasst von:
Lorenzo Berra, Theodor Kolobow, Patrice Laquerriere, Betsey Pitts, Simone Bramati, Joshua Pohlmann, Chiara Marelli, Miriam Panzeri, Pietro Brambillasca, Federico Villa, Andrea Baccarelli, Sylvie Bouthors, Henry T. Stelfox, Luca M. Bigatello, Joel Moss, Antonio Pesenti
Erschienen in:
Intensive Care Medicine
|
Ausgabe 6/2008
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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 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).