TY - JOUR T1 - Bench Comparison of Two Adult Endotracheal Tube Clearing Devices JF - Respiratory Care VL - 64 IS - Suppl 10 SP - 3238788 AU - John Steven Emberger AU - Tom Gillin AU - Kathleen Bonis Y1 - 2019/10/01 UR - http://rc.rcjournal.com/content/64/Suppl_10/3238788.abstract N2 - Background: Two devices are available to clear partial occlusions of the adult endotracheal tube (ETT). Both devices claim the removal of secretions and biofilm from the ETT. There is limited information in the published literature about these devices and to our knowledge, no head to head comparisons on the performance of these devices to clear the lumen of a partially occluded ETT. We wanted to compare both devices in a bench model with simulated mucus for effectiveness to clear the ETT of a partial obstruction. Methods: A bench study was performed to test both devices: Restore 2, endOclear LLC (a balloon tipped catheter with a wiper) and CAM Rescue Cath, Omneotech (a balloon tipped catheter with mesh covering). A Drager V500 with volume-controlled settings was connected to an ASL 5000 test lung via an ETT. An adult size 8.0 ETT was tested with a sequence of 3 partial occlusions for each device. The occlusions were created with simulated mucus (a propylene glycol mixture that was colored blue - within the published range of human mucus viscosity). The occlusions were created by depositing approximately 2 mL of simulated mucus until there was a brief airway occlusion as noted on the ventilator. The devices were evaluated after a single pass of the catheter. Pressure-volume loops as well as breath to breath resistance measurements from the ventilator were used to evaluate the effectiveness of each device to clean the ETT lumen. Results: Average resistance measurements (cm H2O/L/s) for an 8.0 ETT with each device were as follows: CAM Rescue Cath: 23 (new ETT), 34 (ETT partially occluded), 24 (post ETT cleaning). Restore 2: 24 (new ETT), 34.5 (ETT partially occluded), 24.5 (post ETT cleaning). Both devices returned the measured resistance to within 1 cm H2O/L/s of a new ETT after clearing the partial obstructions of simulated mucus. Upon inspection of the endotracheal tubes post cleaning, the Restore 2 had no visible blue color remaining, but the CAM Rescue Cath left a visible film of blue throughout the endotracheal tube. See figure for a representative set of pressure-volume loops displaying the partial obstruction and the loop after cleaning the ETT. Conclusions: Both devices fully restored the original lumen of the ETT in our bench study after clearing a simulated partial occlusion based on the resistance measurements and pressure-volume loops. The Restore 2 visibly removed the blue coloring but with the CAM Rescue Cath a blue film was visible after cleaning. Pressure-volume loops: new ETT, partial occlusion and post cleaning of both ETT cleaning devices ER -