title: Prevention of intubation-induced mucosal damage using a tube coated with 2-methacryloyloxyethyl phosphorylcholine polymer.
abstract: OBJECTIVE
  Tracheal intubation is associated with various complications that include epithelial injury. Abrasion of the fragile tracheal epithelium can occur at the points of contact between the tube and mucosa subject to respiratory movement. In this original experiment, we examined the mucosal protective effect of coating endotracheal tubes with poly[2-methacryloyloxyethl phosphorylcholine (MPC)-co-n-butyl methacrylate] (PMB).
  
  
  METHODS
  We prepared four types of tubes: tube A (control, no coating), tube B (two coats, 0.5% PMB), tube C (10 coats, 0.5% PMB) or tube D (one coat, 5% PMB). Twenty-nine beagle dogs were divided into four groups and orally intubated with tube A, B, C or D for 4±0.5 h. The cuffs of extubated tubes were stained with haematoxylin. Paraffin sections from tracheal walls in contact with the inflated cuff were stained with haematoxylin/eosin and periodic acid-Schiff.
  
  
  RESULTS
  Cuffs of tubes A and B were strongly stained with haematoxylin because of attached epithelial cells. Stained areas in those of tubes C and D were significantly reduced. Histological analysis showed that a single coat of 5% PMB prevented epithelial abrasion and proliferation of goblet cells. Excess tracheal mucus was observed in the tube A group, but not in the tube D group.
  
  
  CONCLUSIONS
  Tracheal epithelial damage caused by intubation was greatly reduced or eliminated by PMB coating on the surface of the tracheal tube.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Ito
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shimohata
authors.forename: Shintaroh
authors.initials: S
authors.lastname: Iwanaga
authors.forename: Wataru
authors.initials: W
authors.lastname: Ito
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohba
authors.forename: Manabu
authors.initials: M
authors.lastname: Mochizuki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Shigeki
authors.initials: S
authors.lastname: Suzuki
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sasaki
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
authors.forename: Ung-il
authors.initials: UI
authors.lastname: Chung
mesh_terms: D000818:Animals; D049109:Cell Proliferation; D004396:Coloring Agents / Q000737:chemistry; D004285:Dogs; D020397:Goblet Cells / Q000378:metabolism; D006416:Hematoxylin / Q000737:chemistry; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D008689:Methacrylates / Q000737:chemistry*; D010767:Phosphorylcholine / Q000031:analogs & derivatives* / Q000737:chemistry; D011108:Polymers / Q000737:chemistry*; D020545:Respiratory Mucosa / Q000166:cytology / Q000293:injuries*; D014132:Trachea / Q000166:cytology / Q000293:injuries
chemical_list: D004396:Coloring Agents; D008689:Methacrylates; D011108:Polymers; D010767:Phosphorylcholine; C079200:poly(2-methacryloyloxyethyl phosphorylcholine-co-n-butyl methacrylate); D006416:Hematoxylin