Photonic designs to reduce morbidity and mortality for ICU patients on ventilators

摘要

Ventilator-associated pneumonia (VAP) is pneumonia that occurs ＞48hrs after initiation of mechanical ventilation and is a significant cause of morbidity and mortality in patients that are hospitalized in intensive care units (ICU). The risk of developing VAP increases during use, and a diagnosis of VAP has been associated with a substantial cost. There are up to hundreds of thousands of cases in the US per year, costing the healthcare system billions annually. Patients who suffer from VAP frequently require longer ICU stays, higher exposure to antibiotics, and more hospital care at the risk of increased mortality. The SARS-CoV-2 pandemic has further increased the use of antibiotics among patients with COVID-19, an indicator of increased VAP prevalence. Before 2020, strides were made to reduce the incidence of VAP through hygienic protocols known as 'VAP bundles.' Despite the improvements, VAP continues to be a large problem, with the inoculation of pathogens within the endotracheal tube (ETT) itself. ETTs with built-in subglottic suction devices (SSD-ETT) allow the removal of subglottic secretions, but this has been adopted heterogeneously. We propose novel optical device designs to be used in combination with SSD-ETTs to reduce colonization and biofilm formation on the inner lumen of ETTs and reduce the incidence of VAP and improve patient care.