S‐Nitroso‐N‐acetylpenicillamine impregnated endotracheal tubes for prevention of ventilator‐associated pneumonia

Abstract

The chances of ventilator‐associated pneumonia (VAP) increases 6–20 folds when an endotracheal tube (ETT) is placed in a patient. VAP is one of the most common hospital‐acquired infections and comprises 86% of the nosocomial pneumonia cases. This study introduces the idea of nitric oxide‐releasing ETTs (NORel‐ETTs) fabricated by the incorporation of the nitric oxide (NO) donor S‐nitroso‐N‐acetylpenicillamine (SNAP) into commercially available ETTs via solvent swelling. The impregnation of SNAP provides NO release over a 7‐day period without altering the mechanical properties of the ETT. The NORel‐ETTs successfully reduced the bacterial infection from a commonly found pathogen in VAP, Pseudomonas aeruginosa, by 92.72 ± 0.97% when compared with the control ETTs. Overall, this study presents the incorporation of the active release of a bactericidal agent in ETTs as an efficient strategy to prevent the risk of VAP.

Prevention of medical device infections via multi‐action nitric oxide and chlorhexidine diacetate releasing medical grade silicone biointerfaces

“…To overcome the challenges associated with bacterial contamination, various surface strategies have been developed in the literature. The SNAP‐incorporated NO‐releasing materials have been widely studied for both antimicrobial and blood‐contacting biomedical device applications 17,48,49 . These polymer systems provide excellent antimicrobial properties that can prolong the lifetime and augment the biocompatibility of medical devices.…”

Nitric oxide and viral infection: Recent developments in antiviral therapies and platforms

“…Endotracheal intubation encumbers normal defense mechanisms of mucociliary clearance and introduces a foreign surface vulnerable to bacterial infiltration and biofilm formation on the endotracheal tube surface, ultimately resulting in high rates of ventilator associated pneumonia (VAP) [163] . NO-releasing endotracheal tubes have recently been shown to reduce bacterial infections in vitro and show promise for VAP reduction as a complication of infections [164] . Additionally, they may serve as a strategy to help manage concurrent viral infections as well as microbial infections.…”

Recent Developments in Multifunctional Antimicrobial Surfaces and Applications toward Advanced Nitric Oxide-Based Biomaterials

“…Moreover, the fabricated NO-releasing non-fouling surface was also found to be non-cytotoxic toward mammalian fibroblast cells. A similar methodology was reported with other SR-based medical devices for the use of urinary catheters and insulin cannula with long-term NO release and reduced SNAP leaching and protein fouling in addition to excellent antibacterial, antifouling, and biocompatible properties. ,, This is a simple and promising approach to generate a LINORel surfaces on prefabricated medical devices and therefore holds huge potential in clinical translation. Recently, a novel method to generate NO-releasing Si oil with proactive antibacterial properties was reported that involved covalent immobilization of the NO donor to Si oil or generation of NO-releasing Si oil by nitrosation of thiolated Si oils. , Such oils can be infused on the PDMS surfaces that are often used for biomedical device applications to create antibacterial interfaces.…”

“…A similar methodology was reported with other SR-based medical devices for the use of urinary catheters and insulin cannula with long-term NO release and reduced SNAP leaching and protein fouling in addition to excellent antibacterial, antifouling, and biocompatible proper- ties. 25,201,207 This is a simple and promising approach to generate a LINORel surfaces on prefabricated medical devices and therefore holds huge potential in clinical translation.…”