Sunday October 12, 2008
Silver-Coated Endotracheal Tubes decreases incidence of Ventilator-Associated Pneumonia?

Interesting study recently published in JAMA 1

Design, Setting, and Participants: Prospective, randomized, single-blind, controlled study from 54 centers in North America. A total of 2003 patients expected to require mechanical ventilation for 24 hours or longer were randomized.

Primary outcome measure: VAP incidence based on quantitative bronchoalveolar lavage fluid culture with 104 colony-forming units/mL or greater in patients intubated for 24 hours or longer.

Other outcomes measures: VAP incidence in all intubated patients, time to VAP onset, length of intubation and duration of intensive care unit and hospital stay, mortality, and adverse event.

Results

• Among patients intubated for 24 hours or longer, rates of microbiologically confirmed VAP were 4.8% (37/766 patients) in the group receiving the silver-coated tube and 7.5% (56/743) in the group receiving the uncoated tube, with a relative risk reduction of 35.9%
• The silver-coated endotracheal tube was associated with delayed occurrence of VAP
• No statistically significant between-group differences were observed in durations of intubation, intensive care unit stay, and hospital stay; mortality; and frequency and severity of adverse events

Conclusion: 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.



Reference: click to get abstract

Silver-Coated Endotracheal Tubes and Incidence of Ventilator-Associated Pneumonia, The NASCENT Randomized Trial , JAMA. 2008;300(7):805-813.