The use of a silver-coated ETT has been proposed
as a method to reduce biofilm production. It is well
known that silver has broad-spectrum antimicrobial
activity, decreases bacterial adhesion in vitro and blocks
biofilm formation in animal models and, therefore,
silver-coated tubes, such as urinary catheters, have
been widely studied. Based on these successes,
silver-coated ETTs were studied in the North American
Silver-Coated Endotracheal Tube (NASCENT) study
and found to be associated with a lower rate of
microbiologically confirmed VAP and a delay in VAP
occurrence when compared to conventional tubes33.
However, this study had several limitations and failed
to show a significant difference in mortality, duration of
mechanical ventilation, and ICU or hospital length of
stay. Further investigation is needed to understand the
potential impact of silver-coated ETTs but preliminary investigations show that despite their relative expense
($90 vs. $2 for a standard ETT) the use of silver-coated
ETTs may result in cost savings.