EAGER: Device for Prevention of Endotracheal Tube Biofilm Formation for the Prevention of Ventilator Associated Pneumonia

知识价值：目前SARS-CoV-2大流行病患者对免疫抑制剂的需求增加。该项目旨在减轻呼吸机相关性肺炎对医院的负担，这将导致所需机械通气时间的总体缩短。VAP是一个世界性的问题，渗透到世界各地的重症监护病房的所有梯队，生物膜被认为是这个持续问题的重要来源。本研究项目旨在构建和研究一种新型装置，通过减少或消除气管内导管（ETT）内生物膜形成的负担来预防VAP。 所提出的装置具有在细菌有机会在气管内导管的内腔上形成生物膜之前将其破坏的潜力，从而以实用且具有成本效益的方式降低了这种对地球仪的医疗保健系统的重大负担的发生率。具体而言，该器械将用于通过经由细导管定期施加深紫外线（UVC）辐射以沿ETT向下馈送，从而减少ETT内腔上的定植和生物膜形成。呼吸治疗师和/或床边护士将使用这种便携式手持设备作为机械通气患者的常规护理的一部分。短波长的UVC不会穿透ETT，从而使口咽和呼吸道粘膜免受辐射照射。更广泛的影响：发生VAP的风险为每1,000个呼吸机日2-16例，VAP的诊断与每位患者40，000美元的额外费用相关。如果该设备能够减轻VAP的负担，那么它在常规ICU护理中的应用每年可以挽救数千人的生命和数十亿美元的资金。拟议的研究将进一步的知识体系的时间轴，其中生物膜内ETT的形成，也将有助于我们的知识无有害物质的去污策略，特别是那些用于在危重病人的床边。此外，这项研究将为目前关于UVC扩散辐射及其在健康人体标准ETT内使用的安全性的知识体系做出巨大贡献。这项工作也将有助于了解无有害物质的净化策略，特别是那些在危重病人床边使用的策略。该奖项反映了NSF的法定使命，并被认为是值得通过使用基金会的知识价值和更广泛的影响审查标准进行评估的支持。

Intellectual Merit: There is an increased need for ventilators for patients suffering from the current SARS-CoV-2 pandemic. This project aims to reduce the burden of ventilator associated pneumonia on hospitals that will lead to an overall reduction in the length of required mechanical ventilation. VAP is a worldwide problem that penetrates all echelons of intensive care units throughout the world, and biofilms are regarded as a significant source of this persistent problem. This research project proposes to build and investigate a novel device for the prevention of VAP by reducing or eliminating the burden of biofilm formation on the inside of endotracheal tubes (ETT). The proposed device has the potential to destroy bacteria before they have a chance to form biofilms on the inner lumen of endotracheal tubes), reducing the incidence of this significant burden on healthcare systems across the globe in a practical and cost efficient manner. Specifically, the device will be used to reduce colonization and biofilm formation on the inner lumen of ETTs by regular application of deep ultraviolet (UVC) radiation via a thin catheter to be fed down the ETT. This portable handheld device would be used by respiratory therapists and/or bedside nurses as part of routine care of mechanically ventilated patients. Short wavelength UVC would not penetrate out and through the ETT, thus sparing the oropharyngeal and respiratory mucosa from radiation exposure. Broader Impact:The risk of developing VAP is 2-16 per 1,000 ventilator-days, and a diagnosis of VAP has been associated with an additional cost of $40,000 per patient. If the proposed device reduces the burden of VAP, its adoption into regular ICU care could save thousands of lives and billions of dollars per year. The proposed research will further the body of knowledge on the timeline by which biofilms form inside ETTs and will also contribute to our knowledge of antibiotic-free decontamination strategies, especially those for use at the bedside of critically ill patients. Additionally, the research will contribute strongly to the present body of knowledge on diffuse UVC radiation and its safety for use inside standard ETTs in healthy humans. This work will also contribute to the knowledge of antibiotic-free decontamination strategies, especially those for use at the bedside of critically ill patients.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.