Silver‐coated endotracheal tube versus non‐coated endotracheal tube for preventing ventilator‐associated pneumonia among adults: A systematic review of randomized controlled trials

@article{Li2012SilvercoatedET,
  title={Silver‐coated endotracheal tube versus non‐coated endotracheal tube for preventing ventilator‐associated pneumonia among adults: A systematic review of randomized controlled trials},
  author={Xiao Li and Qiang Yuan and Li Wang and Liang Du and Lijing Deng},
  journal={Journal of Evidence‐Based Medicine},
  year={2012},
  volume={5}
}
Objective: To compare the effects of using silver‐coated endotracheal tube (ETT) versus non‐coated ETT on the incidence of ventilator‐associated pneumonia (VAP) and mortality in adult patients. 
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TLDR
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TLDR
Modifications to the endotracheal tube that attempt to prevent bacteria from entering around the ETT include maintaining an adequate cuff pressure against the tracheal wall, changing the material and shape of the cuff, and aspirating the secretions that sit above the cuff.
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References

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Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: the NASCENT randomized trial.
TLDR
Patients receiving a silver-coated endotracheal tube had a statistically significant reduction in the incidence of VAP and delayed time to VAP occurrence compared with those receiving a similar, uncoated tube.
Association between a silver-coated endotracheal tube and reduced mortality in patients with ventilator-associated pneumonia.
TLDR
It is suggested that a silver-coated ETT was associated with reduced mortality in patients who developed VAP in the NASCENT study, and inappropriate antibiotics remained in the model.
Silver-coated endotracheal tubes associated with reduced bacterial burden in the lungs of mechanically ventilated dogs.
TLDR
It is suggested that the silver coating of endotracheal tubes may delay the onset of and decrease the severity of lung colonization by aerobic bacteria.
Cost-Effectiveness Analysis of a Silver-Coated Endotracheal Tube to Reduce the Incidence of Ventilator-Associated Pneumonia
TLDR
The silver-coated endotracheal tube represents a strategy for preventing VAP that may yield hospital savings and, in multivariate sensitivity analyses, yielded persistent savings per case of VAP prevented.
Reduced burden of bacterial airway colonization with a novel silver-coated endotracheal tube in a randomized multiple-center feasibility study*
TLDR
In this prospectively planned, preliminary analysis, the RIC device was feasible and well tolerated and larger studies are needed to determine whether delayed colonization, reduced colonization rate, and decreased bacterial burden will decrease the incidence of ventilator-associated pneumonia.
Endotracheal Tubes Coated with Antiseptics Decrease Bacterial Colonization of the Ventilator Circuits, Lungs, and Endotracheal Tube
TLDR
Coated ETTs induced a nonsignificant reduction of the tracheal colonization, eliminated or reduced (one of eight) bacterial colonization of the ETT and ventilator circuits, and prevented lung bacterial colonization.
Antimicrobial-coated endotracheal tubes: an experimental study
TLDR
Several effective and durable antibacterial coatings for ETTs are described, particularly SSD-ETT showed prevention against P. aeruginosa biofilm formation in a 72-h in-vitro study and lower respiratory tract colonization in sheep mechanically ventilated for 24 h.
Implications of endotracheal tube biofilm for ventilator-associated pneumonia
TLDR
Susceptibility data for these pairs show that the ET acts as a reservoir for infecting microorganisms which exhibit significantly greater antibiotic resistance than their tracheal counterparts.
Nosocomial pulmonary infection: Possible etiologic significance of bacterial adhesion to endotracheal tubes
TLDR
The mechanism by which endotracheal tubes repeatedly inoculate the lungs of intubated patients may prove to be dislodgment of such aggregates by suction apparatus.
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