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

智力优势：目前患有SARS-CoV-2大流行的患者对呼吸机的需求增加。该项目旨在减轻医院呼吸机相关肺炎的负担，这将导致所需机械通气时间的总体减少。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级，生物膜被认为是这一持久问题的重要来源。本课题拟建立和研究一种新型装置，通过减少或消除气管内生物膜形成的负担来预防VAP。提出的设备有可能在细菌有机会在气管内管的内腔上形成生物膜之前将其消灭，以实用和经济的方式减少全球医疗保健系统的这一重大负担的发生率。具体来说，该装置将通过一根细导管定期施加深紫外线（UVC）辐射，从而减少ETT内腔的定植和生物膜的形成。这种便携式手持设备将被呼吸治疗师和/或床边护士用作机械通气患者常规护理的一部分。短波长的UVC不会穿透和穿过ETT，从而使口咽和呼吸粘膜免受辐射照射。更广泛的影响：发生VAP的风险为每1000个呼吸机日2-16例，诊断为VAP与每位患者40,000美元的额外费用相关。如果提议的设备减轻了VAP的负担，将其纳入常规ICU护理可以每年挽救数千人的生命和数十亿美元。拟议的研究将进一步了解生物膜在肠内形成的时间轴，也将有助于我们了解无抗生素去污策略，特别是那些用于危重病人床边的策略。此外，这项研究将有力地促进目前关于漫射紫外线辐射及其在健康人的标准ETTs内使用的安全性的知识体系。这项工作还将有助于了解无抗生素去污策略，特别是那些用于危重病人床边的策略。该奖项反映了美国国家科学基金会的法定使命，并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，被认为值得支持。

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.