Ventilator-Associated Pneumonia and the Effectiveness of Endotracheal Tubes Coated with Silver Sulfadiazine

Ventilator-associated pneumonia (VAP) is a consequence of intubation and mechanical ventilation. Bacteria colonize the inner-lumen of endotracheal tubes (ETT) and develop into a biofilm. One method to reduce/eliminate the develop of biofilms within the ETT is lining the inner-lumen with silver-sulfadiazine. A systematic review was conducted to evaluate the effectiveness of silver-coated ETTs for patients that develop VAP. Multiple databases were searched to identify key literature related to silver-coated ETTs and VAP. Inclusion and exclusion criteria were identified to finalize the studies that were included in this systematic review. Five key studies were included in this review. Studies were further evaluated with PRISMA, a data collection table, the Critical Appraisal Skills Programme (CASP) and the Critical Appraisal for Summaries of Evidence (CASE) worksheet. All studies found either a reduction or elimination of bacteria within the ETT, breathing circuit, or lungs of the study subjects. In addition to the reduced colonization found across the studies, one study found a reduction in the mortality rate for the intervention group following a diagnosis of VAP. Certified Registered Nurse Anesthetists (CRNA) play an important role in educating staff about the impact silver-coated ETTs have on patient outcomes throughout periods of intubation and mechanical ventilation. Additionally, CRNAs are well positioned to identify patients pre-operatively that may require prolonged intubation following surgery. By advocating for silver-coated ETTs for these patients, CRNAs can improve patient outcomes by reducing the likelihood of these patients developing VAP