{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:55:29Z","timestamp":1790877329653,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T00:00:00Z","timestamp":1536019200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Biofilm on the surface of endotracheal tubes (ETTs) is associated with ventilator-associated pneumonia. The use of silver-coated ETTs has been suggested to reduce the occurrence of ventilator-associated pneumonia by preventing biofilm formation. However, mucus accumulation can reduce the antibacterial activity of silver-coated ETTs by isolating bacterial colonies from the silver surface. We hypothesized that, in mechanically ventilated subjects, periodic removal of secretions through the use of a cleaning device would enhance the antimicrobial properties of silver-coated ETTs and thus reduce bacterial colonization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Subjects were randomized to either standard suctioning (blind tracheal suctioning, control group) or blind tracheal suctioning plus cleaning maneuver every 8 h (treatment group). Tracheal aspirates were collected immediately before extubation for microbiological culture. After extubation, ETTs were collected for both cultural and non-cultural microbiological analysis and biofilm isolation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      39 subjects expected to be ventilated for &gt; 48 h were enrolled; 36 ETTs (18 control, 18 treatment) and 29 tracheal samples (15 control, 14 treatment) were collected. Among the ETTs positive for bacterial colonization (15 vs 9,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .18), cleaning maneuvers did not reduce microbial load, shown as the decimal logarithm of colony-forming units (CFU) per mL (1.6 \u00b1 1.2 vs 0.9 \u00b1 1.2 logCFU\/mL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .15). There was a trend toward decreased biofilm deposition (439.5 \u00b1 29.0 vs 288.9 \u00b1 157.7 mg,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .09) in the treated ETTs. No significant differences were observed in the number of positive tracheal aspirates (13 vs 10,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .39) or in the microbial load (4.8 \u00b1 4.0 vs 4.2 \u00b1 3.8 logCFU\/mL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .70) of tracheal secretions. Finally, no differences in the microbial load of Gram-positive organisms, Gram-negative organisms, or yeasts were found between the ETTs and tracheal aspirates of the 2 groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In 39 critically-ill subjects intubated with silver-coated ETTs, periodic cleaning maneuvers did not decrease bacterial colonization of the ETTs and did not lower respiratory tract colonization compared to the standard suctioning. (Clinicaltrials.gov registration NCT02120001.)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.06222","type":"journal-article","created":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T12:05:26Z","timestamp":1536062726000},"page":"1-9","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Silver-Coated Endotracheal Tubes Cleaned With a Mechanism for Secretion Removal"],"prefix":"10.1177","volume":"64","author":[{"given":"Massimiliano","family":"Pirrone","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts."},{"name":"Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David AE","family":"Imber","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Marrazzo","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Pinciroli","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts."},{"name":"Department of Anesthesia and Critical Care Service 1, ASST Niguarda Hospital, University of Milan-Bicocca, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changsheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Bry","sequence":"additional","affiliation":[{"name":"Massachusetts Host-Microbiome Center, Department of Pathology, Brigham &amp; Women's Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary L","family":"Delaney","sequence":"additional","affiliation":[{"name":"Massachusetts Host-Microbiome Center, Department of Pathology, Brigham &amp; Women's Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M","family":"Dubois","sequence":"additional","affiliation":[{"name":"Massachusetts Host-Microbiome Center, Department of Pathology, Brigham &amp; Women's Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G","family":"Thomas","sequence":"additional","affiliation":[{"name":"Allegheny Health Network Center of Excellence in Biofilm Research, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Nistico","sequence":"additional","affiliation":[{"name":"Allegheny Health Network Center of Excellence in Biofilm Research, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Melton-Kreft","sequence":"additional","affiliation":[{"name":"Allegheny Health Network Center of Excellence in Biofilm Research, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward A","family":"Bittner","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M","family":"Kacmarek","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts."},{"name":"Department of Respiratory Care, Massachusetts General Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Berra","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,9,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0785-0"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02722"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000255"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc11357"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000455"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.99.13354699"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.27.9.2014-2018.1989"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200505000-00028"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0268-5"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-016-1698-z"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.3.863"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-008-1099-3"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.7.805"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0125-6"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-015-0156-z"},{"issue":"5","key":"e_1_3_2_17_2","first-page":"343","article-title":"[Study on antibacterial property of silver loaded titanium dioxide antibacterial coated endotracheal intubation tube]","volume":"26","author":"Jiang X","year":"2014","unstructured":"Jiang X, , Wang Y, , Hua J, , Lyu B. [Study on antibacterial property of silver loaded titanium dioxide antibacterial coated endotracheal intubation tube]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 2014; 26(5):343\u2013346.","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02995"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04363"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/1751143716644461"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02220-13"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200406000-00017"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.2.818-825.2000"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.46022-0"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000242154.49632.B0"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-008-1100-1"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-008-1016-9"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.01099"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-2048-5"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/78.5.557"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002764"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc13837"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201104-0630OC"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.06222","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.06222","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.06222","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:27:04Z","timestamp":1775467624000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.06222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,4]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.4187\/respcare.06222"],"URL":"https:\/\/doi.org\/10.4187\/respcare.06222","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2018,9,4]]}}}