2010 OPEN FORUM Abstracts
EVALUATION OF 3 TYPES OF ENDOTRACHEAL TUBES WITH SUBGLOTTIC SUCTION CAPABILITIES.
John Davies, Mike Becker, Stephanie Keeting, Neil R. MacIntyre; Duke Medical Center, Durham, NC
Background: Ventilator associated pneumonia (VAP) is a major health concern for patients and cost for hospitals. For this reason, many institutions have adopted the bundle method to help prevent VAP. One key component is elevation of the head 30 45 degrees. Despite this intervention secretions may still accumulate above endotracheal tube (ETT) cuffs. These secretions can become troublesome when they slip around the cuff and into the lower respiratory tract. A new ETT design used by several manufacturers incorporates a suction lumen whose outlet is situated above the cuff. Hypothesis: This bench study was designed to evaluate and compare the suction effectiveness of the commercially available ETTs that have the subglottic suction capability. Methods: Sizes 7.0 mm, 7.5 mm, and 8.0 mm each of the ISIS® (Teleflex Medical, Research Triangle Park, NC), Hi-Lo Evac (Mallinckrodt Medical, St. Louis, MO) and Portex SACETT® (Smiths Medical ASD Inc, Weston MA) ETTs were evaluated. Five of each brand of ETT were tested. The ETTs were inserted into a glass tube mounting rack held at a 30 degree angle and conditioned at 37 degrees C by passing heated air through a Neptune humidifier (Teleflex Medical, Research Triangle Park, NC). Three liquids of differing viscosities were used for comparison water (viscosity 1.02 cP), vegetable oil (canola/soybean blend, viscosity 39.12 cP) and 10W30 motor oil (viscosity 64.71 cP). 10 ml, inserted above the ETT cuff, was used for each test run. Continuous suction of 20 mmHg was applied to the suction port on the ETTs and timing began with a stopwatch. Timing stopped when an audible gurgle sound was heard (indicating that the fluid was completely removed). Results were compared using ANOVA and t tests with the Bonferroni correction for p < 0.05. Results: The suction time to gurgle with water was the same for all brands of ETTs. Means, standard deviations and significance are displayed in the table below. Conclusion: There are differences in rate of clearance of liquids with different properties using these systems. Sponsored Research - This study was supported by an unrestricted educational grant(travel to the Congress only) from Teleflex Medical. However, the study was done independantly from any Teleflex employees and took place in Duke Medical Center. * ISIS vs. Hi-Lo Evac statistically significant for like size ETTs per liquid ISIS vs. SACETT statistically significant for like size ETTs per liquid ¥ Hi-Lo Evac vs. SACETT statistically significant for like size ETTs per liquid