Epithelial lining inspired protective shield for prolonged endotracheal intubation

Abstract

Endotracheal intubation often suffers from side effects due to inherent defects of the endotracheal tube (ETT) itself, posing a formidable challenge for minimally invasive medical interventions. Inspired by biological functions of the epithelial lining, a novel concept of a protective shield is proposed and engineered onto the surface of commercially-available ETTs via a gas-phase fluorination technology. The direct gas-solid reaction enables fluorinated decoration adaptively to both outer and inner surfaces of ETTs for all-round protection. The protective shield composed by the fluorinated coating not only shows high stability to harsh conditions, excellent hydrophilic lubrication, and good biocompatibility, but also exhibits a favorable anti-biofouling property to a broad spectrum of biofoulings and strong antimicrobial activity against Klebsiella pneumoniae. Crediting the above merits, in vivo experiments affirm that the ETT with the protective shield is efficacious to migrate intubation-related complications in two aspects: reducing mucosal injury and inflammation caused by the outer surface friction, and preventing biofilm formation and airway obstruction to maintain inner tube patency. This work opens an avenue for updating EETs to meet clinic needs and holds promise towards the development of invasive biomedical devices.