A polyurethane cuffed endotracheal tube is associated with decreased rates of ventilator-associated pneumonia.
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.
Miller
Melissa A
MA
Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA. melmille@umich.edu
Arndt
Jennifer L
JL
Konkle
Mark A
MA
Chenoweth
Carol E
CE
Iwashyna
Theodore J
TJ
Flaherty
Kevin R
KR
Hyzy
Robert C
RC
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
D011140:Polyurethanes