Tuesday February 2, 2010
Silver Coated ETT?

Objective To determine whether a silver-coated endotracheal tube would reduce the incidence of microbiologically confirmed VAP.

Design Prospective, randomized, single-blind, controlled study conducted in 54 centers in North America. A total of 9417 adult patients were screened between 2002 and 2006. A total of 2003 patients expected to require mechanical ventilation for 24 hours or longer were randomized.

Main Outcome Measures Primary outcome was 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 were 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 events.


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) (P = .03) 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 (P = .005)
• 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.


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