meditation objectives: To evaluate the influence of silver-coated endotracheal tubes forward the lung bacterial burden of mechanically ventilated dogs.

Design: Randomized, double-blinded, controll experiment.

Setting: Animal research facility of a regional medical university.

Patients or participants: Eleven healthy adult dogs.

Interventions: The dogs were intubated either with buffeted noncoated endotracheal tubes or with endotracheal tubes having a novel antimicrobial silver hydrogel coating and were challenged with buccal administration of Pseudomonas aeruginosa.

Measurements and results: The silver coating delayed the appearance of bacteria in succession the inner surface of the endotracheal tubes ([mean [+ or -] SD] duration of mechanical ventilation before appearance of bacteria, 32 [+ or -] 08 days; mean duration of mechanical ventilation, 18 [+ or -] 04 days; p = 0016) The mean total aerobic bacterial weight in the lung parenchyma was statistically lower among the dogs receiving the silver-coated endotracheal tubes compared to those not receiving them (48 [+ or -] 08 v 54 [+ or -] 09 log cfu/g lung tissue, respectively; p = 0010) Pronounced differences were seen in the gros and histologic assessments of inflammation in the lung Using an increasing severity scale of 0 to 12 to assess four composings of histology (ie, hyperemia, edema, cellular infiltration, and bacterial presence) dogs receiving noncoated endotracheal tubes had statistically greater histology scores compared to dogs receiving silver-coated endotracheal tubes (71 [+ or -] 16 v 28 [+ or -] 12 respectively; p < 0001)

Conclusion: These deductions suggest that the silver coating of endotracheal tubes may delay the assault of and decrease the severity of lung colonization by way of aerobic bacteria. Based on these outcomes clinical studies are planned to determine the safety and clinical efficacy of silver-coated endotracheal tubes in patients requiring mechanical ventilation in the ICU setting.

lock opener words: aspiration; critical care; endotracheal tube; mechanical ventilation; outcomes; Pseudomonas aeruginosa; silver; ventilator-associated pneumonia

Abbreviation: SDD = selective digestive decontamination

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Ventilator-associated pneumonia is the in the greatest degree common hospital-acquired infection among patients requiring mechanical ventilation, resulting in excess-mortality and continue lengthen in timeed lengths of hospitalization. (1-6) The colonization of the aerodigestive tract with pathogenic bacteria and the succeeding aspiration of contaminated secretions into the lower airways appears to be the most numerous important mechanism for the growth of ventilator-associated pneumonia. (7) Therefore, clinical strategies aimed at preventing bacterial colonization of the armed force and aspiration have been greatest in number extensively investigated for the prevention of this nosocomial infection. (8) Biofilm formation upon the surface of endotracheal tubes has been implicated as an important promoter of bacterial colonization of the lower airway and as a cause of ventilator-associated pneumonia. (910) These biofilms harbor large concentrations of bacteria that display an inherent resistance to therapy with systemically administered antibiotics. (1112) This may encourage the emerging see the verb of antibiotic-resistant bacteria within the biofilm that subsequently can colonize the respiratory tract of the patient. (9)

The silver coating of urinary catheters has been associated with a reduc incidence of urinary tract infections. (1314) This has been hypothesized to come into view by the antibacterial properties of silver and its ability to stop biofilm formation. (12) Therefore, we performed a prospective, double-blinded, randomized pilot investigation to proof the hypothesis that the use of a silver-coated endotracheal tube could form the burden of aerobic bacteria within the lung parenchyma of mechanically ventilated dogs.

MATERIALS AND METHODS

thought Location and Study Population

The close attention was conducted at the Animal Resources Center of the University of Calgary (Alberta, Canada). Twelve healthy adult dogs were engageed for this investigation. This studious mood was approved by the ethical review board of the Animal Use Committee, Faculty of Medicine, University of Calgary. The care and handling of the animals were in accordance with the guidelines and policies of dutiful animal practice as established by the agency of the Canadian Council on Animal Care.

General application of mind Design

A prospective, double-blinded, controll application of mind design was employed. In this consideration dogs were randomly assigned to be orally intubated either with a silver-coated endotracheal tube or a noncoated endotracheal tube. The animal care providers were blinded to the animals' subject of attention group assignments and all interpretation of the microbiology data and histology data were performed by means of blinded observers. The animals were assigned to their inquiry groups using a random-number generator. The major extreme point point of this pilot close attention was the bacterial burden of the endotracheal tube surface, airways, and lung parenchyma.

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