Ceragenin Coated Endotracheal Tubes for the Prevention of Ventilator Associated Pneumonia

Critically ill patients are at high risk of acquiring pneumonia during the time that they are mechanically ventilated. This is known as ventilator-associated pneumonia (VAP). VAP results in increased duration of mechanical ventilation, increased ICU and hospital stay, increased risk of death and increased health care costs. VAP occurs in 20% of patients and it is estimated that each case of VAP costs the health care system $10 to 15,000 Canadian. Because of its impact on patient outcomes and the health care system, VAP is regarded as an important patient safety issue and there is an urgent need for better prevention strategies.Invasive mechanical ventilation requires the passage of an endotracheal tube (ETT) through the pharynx which is frequently colonized with bacterial pathogens and a bio-film rapidly forms on the ETT. VAP results either from aspiration of contaminated oropharyngeal secretions or from aspiration of bacteria from the bio-film. In this project, we are testing the efficacy of a novel ETT coated with an antibiotic compound that has been shown to reduce the formation of bio-film and pathogen colonization. We will test whether utilization of this novel ETT reduces the occurrence of VAP and improves patient outcomes through a pragmatic, prospective, longitudinal, interrupted time, cross-over implementation study.

Inclusion Criteria:Adult critically ill patients with respiratory failure requiring intubationExclusion Criteria:Admission to hospital or ICU with a non-study ETT already in placePresence of a tracheostomy on ICU admissionUnable to be intubated with non-study ETTDeclined participation in research or data collection