Table of Contents
ISRN Critical Care
Volume 2013, Article ID 812964, 6 pages
Research Article

Impact of a Low-Pressure Polyurethane Adult Endotracheal Tube on the Incidence of Ventilator-Associated Pneumonia: A before and after Concurrence Study

1Florida Gulf to Bay Anesthesiology Associates LLC., Tampa, Florida, USA
2University of Tennessee, Department of Family Medicine, Knoxville, TN, USA
3Indiana University, Department of Family Medicine, Indianapolis, IN, USA
4Tampa General Hospital, Department of Infection Prevention, Tampa, FL, USA
5University of Maryland, Department of Public Health, College Park, MD, USA

Received 31 May 2013; Accepted 6 July 2013

Academic Editors: N. Q. Nguyen and S. J. Verbrugge

Copyright © 2013 John Schweiger et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care unit (ICU) patients, encompassing up to 15% of all hospital acquired infections. Our hospital implemented a facility-wide conversion from a low-volume high-pressure polyvinyl cuffed endotracheal tube (PV-cuffed ETT) to a high-volume low-pressure (HVLP) polyurethane-cuffed endotracheal tube (PU-cuffed ETT) in an effort to reduce the incidence of VAP. Methods. We completed an IRB approved, retrospective chart review comparing the number of episodes of VAP 12 months preceding and following the introduction of a new ETT. A diagnosis of VAP was made based upon the guidelines of our institution, consistent with the Center of Disease Control and Prevention definition. Results. The number of patients developing VAP the year after the ETT conversion reduced to 32 (16.3%) from 68 (24.7%) the year before the conversion ( ). The rate of VAP was reduced by 56% per ventilator day after the implementation of the PU-cuffed ETT ( ). No significant differences were observed in length of hospital stay, length of mechanical ventilation, or mortality before or after the conversion. Conclusions. We found that HVLP PU-cuffed ETTs were associated with a statistically significant reduction of VAP in the adult ICUs.