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Assessment of Nanomodified Endotracheal Tubes in a Bench Top Airway Model

Published online by Cambridge University Press:  31 January 2011

Mary C. Machado ,
Daniel Chang ,
Thomas J Webster  and
Keiko M Tarquinio
Mary C. Machado
Affiliation:
mary_machado@brown.edu
Daniel Chang
Affiliation:
daniel_chang@brown.edu, Brown University, Providence, United States
Thomas J Webster
Affiliation:
thomas.webster@scholarone.com, Brown University, Providence, United States
Keiko M Tarquinio
Affiliation:
ktarquinio@Lifespan.org, Rhode Island Hospital, Providence, United States
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Abstract

Ventilator associated pneumonia (VAP) is a serious and costly clinical problem. Specifically, receiving mechanical ventilation over 24 hours increases the risk of VAP and is associated with high morbidity, mortality and medical costs. This complication is especially hard to diagnose in children because of non-specific clinical signs and lack of established diagnostic methods. Cost effective endotracheal tubes (ETTs) that are resistant to bacterial infection would be essential tools for the prevention of VAP. In addition to their bacterial resistance, ETT with magnetic nanoparticles could aid in the diagnosis of VAP allowing physicians to locate infections with greater accuracy. The objective of this study was twofold, first to develop strategies to decrease bacterial adhesion on nano-rough ETT and secondly to develop better methods to assess in vitro bacterial adhesion or biofilm formation on ETT. In preliminary tests, nanomodified polyvinyl chloride (PVC) ETTs has been shown to be effective at reducing bacterial colonization. This study also sought to evaluate the bacterial resistance of these ETTs more effectively by creating a bench top airway model, which can create a similar environment to the flow system that ETTs are exposed to in vivo. The airway model designed to test ETTs has two Plexiglas chambers representing the oropharynx and the lungs, a tube representing the trachea and finally an intricate pumping system to the oropharynx with bacteria flow and to the lung with simulated compliance and resistance. ETTs were connected to a ventilator and passing the oropharynx into the trachea and observed under the mechanical ventilation and continuous bacterial flow system. In addition, the study examined dual gas flow conditions and their effect on bacterial growth of ETT. In no less than three separate trials in the airway chamber, each ETT will be tested for its effectiveness at the reduction of bacterial growth within the airway by sampling from both lung and oropharynx chambers during continuous operation. Special attention will be given to the long-term effects on the ETT by including a study that lasts longer than ten days. Both the bacterial proliferation in the two chambers and on the ETT itself will be carefully analyzed. This specialized testing should yield valuable information on the efficacy of nanomodified ETT in airway conditions and will provide further evidence to determine if nanomodified ETTs are a valid solution to VAP.

Keywords

nanostructurenanoscalescanning electron microscopy (SEM)
Type
Research Article
Information
MRS Online Proceedings Library (OPL) , Volume 1209: Symposia P/YY – Business and Safety Issues in the Commercialization of Nanotechnology , 2009 , 1209-YY08-06
Copyright
Copyright © Materials Research Society 2010

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References

1Office of Quality and Performance, FY 2008, Q1 technical manual for the VHA performance measurement system, Oct, pp. 315 (2007).Google Scholar
2 Bahrani-Mougeot, F. K., Paster, B. J. and Coleman, S. “Molecular analysis of oral and respiratory bacterial species associated with ventilator-associated pneumonia,” J Clin Microbiology 45, 1588–1593 (2007).Google Scholar
3 Liu, H. and Webster, T. J., “Nanomedicine for implants: a review of studies and necessary experimental tools.” Biomaterials, 28, 354–369 (2007).Google Scholar
4 Carson, S. Fibronectin in Health and Disease New York: CRC Press, Inc. (2007).Google Scholar
5 Marini, J. J. and Slutsky, A. S., Physiological basis of ventilatory support. New York: Marcel Dekker (1998).Google Scholar
6 Cardinal, P. Jessamine, P. Carter-Snell, C., Morrison, S. and Jones, G.. (1993), “Contribution of Water Condensation in Endotracheal Tubes to Contamination of the Lungs.” Chest, 127–129 (1993).Google Scholar
7 Hartmann, M. Guttmann, J. Muller, B. Hallmann, T. and Geiger, K. “Reduction of the bacterial load by the silver-coated endotracheal tube (SCET) a laboratory investigation.” Technology and Health Care, 359–70 (1999).Google Scholar
8National Center for Health Statistics, Center for Disease Control and Prevention, Clinical Growth Charts, August, Set 1 (2009)Google Scholar
9 Cheng, D. and Webster, T. J., “Formation of nano surfaces on endotracheal tubes using bacterial lipase solutions.” Bioengineering Conference, IEEE 35th Annual Northeast, 1-2 (2008).Google Scholar
10 Wilson, W. C., Grande, C. M., and Hoyt, D. B., Trauma Emergency Resuscitation, Perioperative Anesthesia, Surgical Management, Volume I. New York: Informa Healthcare (2007).Google Scholar
11 Soderholm, K.-J.M. Mukherjee, R. and Longmate, J. “Filler Leachability of Composites Stored in Distilled Water or Artificial Saliva.” Journal of Dental Research, 1692-1699 (1996).Google Scholar
12 Balasundaram, G. and Webster, T. J., “Nanotechnology and biomaterials for orthopedic medical applications.” Nanomedicine, 1(2): 169–176 (2006)Google Scholar