A NEW METHOD TO COMPLETELY CLEAN THE TRACHEAL TUBE (ETT), FREE OF ALL MUCUS/SECRETIONS

Abstract

Purpose of the study To maintain the ETT totally free of mucus/ secretion/bacterial biofilm. Methods used Anesthetized, paralyzed sheep intubated with a silver sulfadiazine in polyurethane-coated ETT, were mechanically ventilated (MV) for 72 h. Every 2 h, we cleaned the ETT with the Mucus Shaver (MS) (Fig.1a): This is a 28 cm long, 3 mm external diameter plastic tube, at one end of which we mounted a 2 cm long thin-walled silicone rubber tube; with two silicone rubber shaving rings (1 mm × 0.5 mm) cemented to the external surface. We inserted the MS into the ETT, inflated it (Fig. 1b), to force the two shaving rings tightly against the interior of the ETT (Fig 1c). and then retrieved the inflated balloon. At autopsy, we removed the ETT for visual inspection and scanning electron microscopy (SEM) studies; and tissue samples from the 5 lobes of the lungs, and the trachea were taken for quantification of bacterial growth. Summarize results On opening the ETT, the internal surface appeared clean, without mucus or secretions. The ETT appeared new. On SEM, there was absence of all bacteria and biofilm. There was no bacterial growth in cultures from the ETT, the trachea, and the five lobes of the lungs.Figure