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Endotracheal Tube Biofilm and Ventilator-Associated Pneumonia

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Annual Update in Intensive Care and Emergency Medicine 2013

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

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Abstract

Ventilator associated pneumonia (VAP) is one of the most relevant infections in intensive care unit (ICU) patients, and its occurrence increases with duration of mechanical ventilation. It is widely accepted that VAP is associated with increased duration of ventilation, hospital stay and health care costs [1]. However, the impact of VAP on mortality is currently under debate; in a cohort of patients with acute respiratory distress syndrome (ARDS), VAP diagnosis was not associated with increased mortality after adjustment for factors, such as age or severity at admission [2]. Because of the pathogenesis of VAP, in recent years, focus has moved to the endotracheal tube (ETT), to the extent that some authors have suggested changing the name from ventilator-associated to ETT-associated pneumonia [3]. When the ETT is in place, the cough reflex is not effective; cuff inflation reduces secretion clearance by altering ciliary activity, as shown in animal models [4]. One of the main mechanisms to explain the inoculum of pathogens into the lungs is related to the presence of a biofilm on the inner lumen of the ETT; microbes can detach from the biofilm and reach the lower airways, leading to lung colonization and VAP. Key biofilm characteristics and possible VAP preventive measures focusing on biofilm reduction will be presented in this chapter.

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Author information

Authors and Affiliations

  1. Department of Experimental Medicine, University of Milano-Bicocca, Monza, Italy

    A. Coppadoro

  2. Department of Pathology, West Virginia University School of Medicine, Morgantown, USA

    J. G. Thomas

  3. Massachusetts General Hospital, Harvard Medical School, Boston, USA

    L. Berra

Authors
  1. A. Coppadoro
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  2. J. G. Thomas
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  3. L. Berra
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Corresponding author

Correspondence to L. Berra .

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Editors and Affiliations

  1. Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent Prof.

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Coppadoro, A., Thomas, J.G., Berra, L. (2013). Endotracheal Tube Biofilm and Ventilator-Associated Pneumonia. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2013. Annual Update in Intensive Care and Emergency Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35109-9_46

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  • DOI: https://doi.org/10.1007/978-3-642-35109-9_46

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-35108-2

  • Online ISBN: 978-3-642-35109-9

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