title: A polyurethane cuffed endotracheal tube is associated with decreased rates of ventilator-associated pneumonia.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA. melmille@umich.edu
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Miller
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Arndt
authors.forename: Mark A
authors.initials: MA
authors.lastname: Konkle
authors.forename: Carol E
authors.initials: CE
authors.lastname: Chenoweth
authors.forename: Theodore J
authors.initials: TJ
authors.lastname: Iwashyna
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Flaherty
authors.forename: Robert C
authors.initials: RC
authors.lastname: Hyzy
mesh_terms: D000328:Adult; D004867:Equipment Design; D006801:Humans; D015994:Incidence; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000517:prevention & control*; D011140:Polyurethanes; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D011140:Polyurethanes