Antimicrobial-coated endotracheal tubes: ETTs coated
with antimicrobial substances have been studied as a
means to decrease bacterial colonization and prevent
biofilm production with the ultimate hope of reducing
VAP rates. It is hypothesized that microorganisms reach
the ETT either as a consequence of a contaminated
oropharynx or reflux of gastric secretions. Once
they reach the ETT surface, microorganisms produce
biofilms, which provide an ideal environment for
growth and proliferation protected from the host’s
natural defenses. When biofilms subsequently become
dislodged, either spontaneously or iatrogenically due
to suctioning or bronchoscopy, there is significant risk
for development of late-onset VAP.