endotracheal tubes
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2022 ◽  
Vol 67 ◽  
pp. 39-43
Teressa Reanne Ju ◽  
Emily Wang ◽  
Christian Castaneda ◽  
Anisha Rathod ◽  
Olumayowa Abe

2022 ◽  
Vol 12 (1) ◽  
Pierre Damas ◽  
Caroline Legrain ◽  
Bernard Lambermont ◽  
Nadia Dardenne ◽  
Julien Guntz ◽  

Abstract Background Ventilator-associated pneumonia (VAP) causes increased mortality, prolonged hospital stay and increased healthcare costs. Prevention of VAP in intensive care units (ICUs) is currently based on several measures, and application of noble metal coating on medical devices has been shown to inhibit the bacterial adherence of microorganisms to the surface. The objective of this study was to evaluate the potential benefit of noble metal coating of endotracheal tubes for the prevention of VAP. Methods This was a multi-center, randomized, controlled, double-blind, prospective study including ventilated patients from nine ICUs from four hospital sites in Belgium. Patients were randomly intubated with identical appearing noble metal alloy (NMA) coated (NMA-coated group) or non-coated (control group) endotracheal tubes (ETT). Primary endpoint was the incidence of VAP. Secondary endpoints were the proportion of antibiotic days during ICU stay and tracheal colonization by pathogenic bacteria. Results In total, 323 patients were enrolled, 168 in the NMA-coated group and 155 in the control group. During ventilation, VAP occurred in 11 patients (6.5%) in the NMA-coated group and in 18 patients (11.6%) in the control group (p  = 0.11). A higher delay in VAP occurrence was observed in the NMA-coated group compared with the control group by Cox proportional hazards regression analysis (HR 0.41, 95% CI 0.19–0.88, p  = 0.02). The number of antibiotic days was 58.8% of the 1,928 ICU days in the NMA-coated group and 65.4% of the 1774 ICU days in the control group (p  = 0.06). Regarding tracheal colonization, bacteria occurred in 38 of 126 patients in the NMA-coated group (30.2%) and in 37 of 109 patients in the control group (33.9%) (p  = 0.57). Conclusions This study provides preliminary evidence to support the benefit of noble metal coating in the prevention of VAP. A confirmatory study in a larger population would be valuable. Trial registration: Clinical trial number: NCT04242706 (http://www.clinicaltrials.gov)

KYAMC Journal ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 153-160
Tanjida Shilpi ◽  
Md Arifur Rahman ◽  
Sabera Sultana ◽  
Shafinaz Khan ◽  
Sunil Krishna Baul

Introduction: Nosocomial infections have been described as an important issue among intubated patients which leads to significant morbidity and mortality. The pattern of microbiological colonization and antibiotic resistance are much valuable in this regard. Objectives: The aim of present study was to determine the pattern of aerobic bacteria isolated from endotracheal tubes in adult patients and determination of their antimicrobial susceptibility patterns. Materials and Methods: Specimens were collected from tracheal tubes of patients with endotracheal aspiration and microbiological investigations were done. The isolated bacteria were identified by using standard cultural and biochemical tests. Then antibiotic susceptibility testing was performed on the isolates by disc diffusion method according to clinical and laboratory Standards Institute (CLSI) guideline. Results: Among 104 participants 68 (65.4%) were female and 36 (34.6%) were male. Most of the patients were in the age group of 71-80 years (48.0%). From 104 positive growths, both Gram positive and Gram negative organisms were found. Maximum samples showed growth of gram negative organism. Antimicrobial susceptibility testing revealed that the most resistant Gram negative isolate was Klebsiella with highest resistance against Vancomycin (40.4%) and which showed highest sensitive against Cefotetan, Cefoxitin and Norfloxain (39.4%). Conclusions: It may be concluded that this study indicates the emergence of antibiotic resistant infections in the studied hospital. So, there is a need to improve the effectiveness of integrated infection control programs to control and manage nosocomial infections caused by highly resistant organisms. KYAMC Journal. 2021;12(3): 153-160

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259596
Sun Young Cho ◽  
Jeong-Hyun Choi ◽  
Seung Hyeun Lee ◽  
Yong-Sung Choi ◽  
Sung Wook Hwang ◽  

Background Although the study of respiratory microbiota has been an active field of research, obtaining the appropriate respiratory samples for healthy controls remains to be a challenge. As such, this study aims to evaluate the use of endotracheal tube washing as a viable control for sputum samples. Methods A total of 14 subjects, including 8 healthy respiratory controls and 6 diabetic patients without any respiratory disease, were enrolled in this study, during which the endotracheal tubes used in their scheduled routine surgery were collected. Pre-operative oral gargles were also collected from non-diabetic subjects. Results 16S amplicon sequencing revealed similar taxa composition in endotracheal tube washings and oral gargles in the healthy control subjects, although the relative abundance of 11 genus level operational taxonomic units was significantly different between the two sample sources. The diabetic subjects showed relatively lower diversity than those of non-diabetic subjects. The proportion range of the most abundant taxa detected in each endotracheal tube washings were 10.1–33.2%. Conclusion Endotracheal tube washing fluid may provide healthy control samples for upper respiratory investigations without incurring any additional risk to the subject.

2021 ◽  
pp. 343-360
Mincho Marroquin-Harris

This chapter provides a basic overview of anaesthetic equipment and its safe use. Topics include the provision of anaesthetic gases, the basic components of the anaesthetic machine, breathing systems, positive-pressure ventilation, and airway equipment including laryngoscopes, endotracheal tubes and supraglottic airway devices. Methods of long-term venous access are discussed.

2021 ◽  
Vol 8 (1) ◽  
Jennifer S. N. Tang ◽  
Jarrel C. Y. Seah ◽  
Adil Zia ◽  
Jay Gajera ◽  
Richard N. Schlegel ◽  

AbstractCorrect catheter position is crucial to ensuring appropriate function of the catheter and avoid complications. This paper describes a dataset consisting of 50,612 image level and 17,999 manually labelled annotations from 30,083 chest radiographs from the publicly available NIH ChestXRay14 dataset with manually annotated and segmented endotracheal tubes (ETT), nasoenteric tubes (NET) and central venous catheters (CVCs).

Jennifer N. Berger ◽  
Timothy G. Elgin ◽  
John M. Dagle ◽  
Jonathan M. Klein ◽  
Tarah T. Colaizy

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1844
Kuo-Ching Yuan ◽  
Lung-Wen Tsai ◽  
Kevin S. Lai ◽  
Sing-Teck Teng ◽  
Yu-Sheng Lo ◽  

Endotracheal tubes (ETTs) provide a vital connection between the ventilator and patient; however, improper placement can hinder ventilation efficiency or injure the patient. Chest X-ray (CXR) is the most common approach to confirming ETT placement; however, technicians require considerable expertise in the interpretation of CXRs, and formal reports are often delayed. In this study, we developed an artificial intelligence-based triage system to enable the automated assessment of ETT placement in CXRs. Three intensivists performed a review of 4293 CXRs obtained from 2568 ICU patients. The CXRs were labeled “CORRECT” or “INCORRECT” in accordance with ETT placement. A region of interest (ROI) was also cropped out, including the bilateral head of the clavicle, the carina, and the tip of the ETT. Transfer learning was used to train four pre-trained models (VGG16, INCEPTION_V3, RESNET, and DENSENET169) and two models developed in the current study (VGG16_Tensor Projection Layer and CNN_Tensor Projection Layer) with the aim of differentiating the placement of ETTs. Only VGG16 based on ROI images presented acceptable performance (AUROC = 92%, F1 score = 0.87). The results obtained in this study demonstrate the feasibility of using the transfer learning method in the development of AI models by which to assess the placement of ETTs in CXRs.

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