Incidence of endotracheal tube colonization with the use of PneuX endotracheal tubes in patients following cardiac surgery. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Senanayake, E.L.; Giri, R.; Gopal, S.; Nevill, A.; Luckraz, H.
• Is Part Of: Journal of hospital infection. Volume 95:Issue 1(2017)
• Page Start: 81
• Page End: 86
• Publication Date: 2017-01
• Subjects: Ventilator-associated pneumonia -- Cardiac surgery -- PneuX endotracheal tube -- Microbial colonization; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2016.09.007
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: Introduction: Ventilator-associated pneumonia (VAP) develops in up to 25% of patients following cardiac surgery. Colonization of the endotracheal tube (ETT) contributes to VAP. The PneuX ETT has been shown to halve VAP in high-risk patients undergoing cardiac surgery. This article reports on the secondary analysis of bacterial colonization in relation to VAP between the PneuX and standard ETTs. Methods: In this randomized controlled trial, patients were randomized on a 1:1 basis to Group A (PneuX ET, N =120) or Group B (standard ETT, N =120). Patients aged >70 years with or without impaired left ventricular function (<50%) undergoing elective and urgent cardiac surgery were included in this study. Incidence of postoperative VAP and analysis of bacterial colonization within the ETT ( N =234) were measured for patients requiring <24 h, 24–48 h and >48 h of intubation. Results: Baseline patient demographics were comparable. VAP was lower in Group A compared with Group B (10.8% vs 21%; P =0.03). The incidence of VAP was lower at each time point for Group A. There was a lower incidence of ETT colonization in Group A for patients needing >48 h of intubation. There was no difference in the type of bacterial colonization ( P =0.5) or the mean number of colony-forming units [4.35x10 7 (1.18x10 8 ) and 2.16x10 8 (1.24x10 9 ) in Groups A and B, respectively ( P =0.8)]. Conclusion: Colonization of the ETT does not seem to play an important role in early-onset VAP. There is a tendency for reduced colonization in the PneuX ETT with longer intubation times. This may have an impact on reducing the incidence of late-onset VAP.