Use of the Airway Medix Closed Suction System (AMCSS) reduces clinical pulmonary infection scores (CPIS), endotracheal tube air flow resistance, and biofilm formation, compared with standard CSS for critically ill patients who require mechanical ventilation for ≥48 hours, according to a study presented here on March 15 at the 2016 International Symposium on Intensive Care and Emergency Medicine (ISICEM).
During the course of mechanical ventilation, the endotracheal tube begins to be colonised with oral bacteria and respiratory pathogens that adhere to its inner surface.
“The goal of this study was to evaluate the efficiency of the AMCSS compared with a standard closed suction system,” explained Michal Pfeffer Intensive Care Unit, Kaplan Medical Centre, Rehovot, and colleagues.
For the study, 80 critically ill patients who required mechanical ventilation for ≥48 hours were randomised to standard CSS (Kimvent; n = 40) or to the AMCSS (n = 40). The full data analysis was performed following the withdrawal of 15 patients from the trial.
The resistance through the endotracheal tube was determined post extubation, and then the endotracheal tubes underwent qualitative and quantitative analysis of biofilm accumulation by scanning electron microscopy.
Patients in the AMCSS group showed significantly lower CPIS compared with the patients in the CSS group (4.9 vs 5.9; P = .036). This benefit was also seen in terms of a reduced proportion of patients with CPIS ≥7 (13.8% vs 33.3%).
Endotracheal tube air resistance was significantly higher for the tubes in the CSS group at test flow rates of 30 L/minute and 60 L/minute (P = .001 for both).
Biofilm stage was lower for the AMCSS group compared with the CSS group (2.29 vs 2.72). Of the tubes in the CSS group, 68.8% developed biofilm stage ≥3 compared with 45.5% of tubes in the CSS group.
“This unique device has proven to be effective in limiting the biofilm development to the early stages,” the authors concluded.
[Presentation title: Final Results of an Evaluation of Airway Medix Closed Suction System Compared to a Standard Closed Suction System. Abstract 223]