1051

Abstract

Introduction: The PneuX Pneumonia Prevention system comprises a flexible silicone tracheal tube (TT) with a non-stick inner lumen parylene coating, a sealing cuff and a continuous cuff pressure control device. Secretions collected inside the TT may cause blockage and serve as a medium for microbial growth that may stay protected from the patient’s immune system and antibiotic penetration. The purpose of this study was to collect initial data in order to examine and compare the amount of secretions on the inner lumen of the PneuX TT and conventional polyvinyl chloride (PVC) TT in the critically ill. Hypothesis: The PneuX TT will have a lower mass of secretion in the lumen of the TT than the PVC tubes. Methods: The study took part in two critical care units (39 tubes). Tracheal tube evaluation was both qualitative (pictures/visual impression) and quantitative (weight difference). Following extubation, tracheal tubes were immediately photographed and weighed (dirty weight). The tracheal tubes were then cleaned and reweighed (clean weight), and the weight of the secretions inside the TT lumen was then calculated (dirty weight - clean weight). Results: The mean mass of TT secretions for the PneuX TT group was 0.21g (SD=0.39; range 0-1.2) and for the PVC TT group 1.02g (SD=0.48; range 0.2-2.2); P<0.001. Photographed TTs were visually more contaminated in the PVC group. Conclusions: There was a significant increase in the accumulation of material in the inner lumen of the PVC TT group compared with the PneuX TT group. There was also a qualitative difference in the contamination of tubes with PVC TT group being visually more contaminated than the PneuX TT group. This could have negative impact in patient care such as increasing the risk of tube obstruction and the perpetuation of infection. Subsequent studies to confirm these findings, to quantify the microbiological load within the TTs and to determine the effect on outcome in terms of ventilator-associated complications are warranted.