Journal of Critical Care
Volume 26, Issue 3 , Pages 280-286, June 2011

A polyurethane cuffed endotracheal tube is associated with decreased rates of ventilator-associated pneumonia☆

  • Melissa A. Miller, MD

      Affiliations

    • Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI
    • Corresponding Author InformationCorresponding author. 3916 Taubman Center, Ann Arbor, MI 48109-5360, USA. Tel.: +1 734 936 5201; fax: +1 734 936 5048.
    • ,
  • Jennifer L. Arndt, MS, CIC

      Affiliations

    • Department of Infection Control and Epidemiology, University of Michigan, Ann Arbor, MI
    • ,
  • Mark A. Konkle, MPA, RRT

      Affiliations

    • Department of Respiratory Care, University of Michigan, Ann Arbor, MI
    • ,
  • Carol E. Chenoweth, MD

      Affiliations

    • Department of Infection Control and Epidemiology, Division of Infectious Diseases, University of Michigan, Ann Arbor, MI
    • ,
  • Theodore J. Iwashyna, MD, PhD

      Affiliations

    • Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI
    • ,
  • Kevin R. Flaherty, MD, MS

      Affiliations

    • Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI
    • ,
  • Robert C. Hyzy, MD

      Affiliations

    • Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI

published online 23 July 2010.

Abstract 

Purpose

The aim of this study was to determine whether the use of a polyurethane-cuffed endotracheal tube would result in a decrease in ventilator-associated pneumonia rate.

Materials and Methods

We replaced conventional endotracheal tube with a polyurethane-cuff endotracheal tube (Microcuff, Kimberly-Clark Corporation, Rosewell, Ga) in all adult mechanically ventilated patients throughout our large academic hospital from July 2007 to June 2008. We retrospectively compared the rates of ventilator-associated pneumonia before, during, and after the intervention year by interrupted time-series analysis.

Results

Ventilator-associated pneumonia rates decreased from 5.3 per 1000 ventilator days before the use of the polyurethane-cuffed endotracheal tube to 2.8 per 1000 ventilator days during the intervention year (P = .0138). During the first 3 months after return to conventional tubes, the rate of ventilator-associated pneumonia was 3.5/1000 ventilator days. Use of the polyurethane-cuffed endotracheal tube was associated with an incidence risk ratio of ventilator-associated pneumonia of 0.572 (95% confidence interval, 0.340-0.963). In statistical regression analysis controlling for other possible alterations in the hospital environment, as measured by rate of tracheostomy-ventilator-associated pneumonia, the incidence risk ratio of ventilator-associated pneumonia in patients intubated with polyurethane-cuffed endotracheal tube was 0.565 (P = .032; 95% confidence interval, 0.335-0.953).

Conclusions

Use of a polyurethane-cuffed endotracheal tube was associated with a significant decrease in the rate of ventilator-associated pneumonia in our study.

Keywords: Pneumonia, Ventilator-associated, Nosocomial infections, Ventilators, Mechanical, Endotracheal tube

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

☆ Funding/Support: This study was partially funded by Kimberly-Clark Corporation, Rosewell, Ga, which manufactures Microcuff. Kimberly-Clark Corporation supplied the Microcuff polyurethane-cuffed endotracheal tubes for the intervention year free of charge. Kimberly-Clark Corporation employees were not involved in the concept, design, or conduct of the study, nor were they involved in the analysis of data or review of the manuscript before submission. Dr Robert Hyzy has received a consulting fee of $5800 in 2008 and a $6000 unrestricted educational grant in 2007 from the Kimberly-Clark Corporation.

PII: S0883-9441(10)00163-2

doi:10.1016/j.jcrc.2010.05.035

Journal of Critical Care
Volume 26, Issue 3 , Pages 280-286, June 2011

Article Tools