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- W2330413307 abstract "Introduction: The adherence of secretions along the endotracheal tube (ETT) lumen in mechanically ventilated (MV) patients results in airway narrowing and concomitantly may increase patients’ work of breathing. Biofilm accumulation may also promote the development of ventilator-associated pneumonia. Routine suctioning does not address the potential risks associated with secretions and biofilm that collect within the ETT lumen. A unique mucus shaver system (endOclear™) facilitates removal of secretions and biofilm. The purpose of this study is to determine the effectiveness of reducing peak airway pressures and resistance in ventilated patients who have their ETT cleared with a mucus shaver system. The hypothesis is: Application of a mucus shaver system in addition to routine suctioning prior to spontaneous breathing trials (SBTs) lowers both peak airway pressures and airway resistance. Methods: This study retrospectively identified all subjects having their ETTs cleared at a single institution prior to beginning a SBT between Jan-Dec 2012. All subjects had received at least 24 hrs of MV prior to the SBT, and all underwent routine suctioning with a closed in-line system prior to use of the mucus shaver. Peak airway pressures before and after the additional use of the mucus shaver along with changes in airway resistance served as our co-primary endpoints. The study also compared changes in these variables as function of the ETT lumen size. Results: The median peak airway pressure measured 29 cmH20 before use of the mucus clearance system and fell to 23 cm H20 (p<0.001). There was a similar decline in the median airway resistance (27 cm H20/Lps to 15 cm H20/Lps, p < 0.001). The average percent decline in peak airway pressure equaled 17.6 ± 13.3% while the mean drop in airway resistance was greater, 33.3 ± 18.9%. Seventy-five percent of subjects experienced a greater than 10% and 19% fall in peak airway pressure and airway resistance, respectively. Differences in ETT lumen size did not alter the magnitude of the fall seen in either of the co-primary endpoints. Conclusions: The addition of a unique mucus shaving and tube cleaning system to routine suction prior to an SBT significantly reduces both peak airway pressure and airway resistance in persons undergoing SBTs." @default.
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- W2330413307 date "2013-12-01" @default.
- W2330413307 modified "2023-09-28" @default.
- W2330413307 title "354" @default.
- W2330413307 doi "https://doi.org/10.1097/01.ccm.0000439498.98645.19" @default.
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