Perhaps one bright spot in the Health and Human Service department’s 2009 quality report, was a reduction in the rates of post-operative pneumonia by 12 percent, however more work is still yet to be done.

"While the pneumonia incidence have shown improvement through 2006, the respiratory failure rates still seem problematic which is why Covidien is focused on all post intubation pulmonary complications (PIPCs)," said Doug Hansell, M.D., M.P.H., chief medical officer and vice president, Covidien Respiratory and Monitoring Solutions. "We believe that the TaperGuard and TaperGuard Evac endotracheal tubes can be an important technology in improving a variety of clinical outcomes related to these complications."

Covidien’s Mallinckrodt TaperGuard

Hansell explained that Covidien’s Mallinckrodt TaperGuard and TaperGuard Evac endotracheal tubes are designed with a taper-shaped cuff that has been shown to significantly reduce microaspiration. "Microaspiration—the movement of secretions into the respiratory tract—is widely viewed as a cause of specific PIPCs, including postoperative and ventilator-associated pneumonias. The overwhelming majority of such microaspiration cases stem from inadequately designed tracheal cuffs that fail to seal the tracheal passageway. Although these air seal gaps are very small – micro in size – they can allow gastric laden secretions or virulent secretions associated with pneumonia to enter into and be dispersed throughout the lungs," he said, adding, "Microaspiration of contaminated oro-pharyngeal and gastrointestinal secretions is a likely and modifiable risk factor for pneumonia. Post-intubation pulmonary complications, like pneumonia, are prevalent and costly for patients and society."

"The addition of the TaperGuard Evac lumen with the standard TaperGuard tube allows the physician to remove the secretions that pool above the cuff, and reduce the risk of them getting in to the lungs," described Hansell. "The TaperGuard cuff reduces microaspiration by an average of 90 percent compared to the Mallinckrodt Hi Lo cuff, which was previously one of the top performing cuffs with regard to sealing performance. In addition, a recently announced in vivo study also concluded that the Mallinckrodt TaperGuard endotracheal tube provided significant protection from microaspiration and lung damage compared to the Mallinckrodt Hi-Lo endotracheal tube."

According to Hansell, data was presented at the New York State Society of Anesthesiologists Post-Graduate Assembly held in New York City showing that in one study, not one patient intubated with TaperGuard endotracheal tubes showed signs of fluid leakage past the cuff (n=11). In contrast more than 40 percent of patients intubated with a conventional high volume low pressure cuff (n=9) exhibited clear evidence of microaspiration.

"When used in surgical procedures and critical care applications, TaperGuard endotracheal tubes will substantially reduce specific and severe risks related to the movement of secretions beyond the tube’s sealing cuff, most notably from pneumonia," he said. "In addition to microaspiration reduction, the Mallinckrodt TaperGuard Evac endotracheal tube has been shown to reduce ventilator-associated pneumonia (VAP) by up to 75 percent."

Continued Hansell, "As a further example of the value of Covidien’s integrated respiratory product portfolio, when the TaperGuard Evac endotracheal tube is used in conjunction with a Puritan Bennett 840 ventilator, clinicians can further reduce the risk of infection because of the ventilator’s inspiratory and expiratory filters. These filters prevent the ventilators from becoming either inspiratory or expiratory transmission vectors for viral and bacterial agents. In addition, Covidien provides DAR filters and Heat and Moisture Exchangers (HMEs) as an effective and economic way to deliver appropriate humidification and protect the safety of mechanically ventilated patients. In a laboratory test of 48 filter and HME products, DAR HMEs ranked among the best for absolute humidity and resistance."

Kimberly-Clark KimVent oral care kit