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

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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.