Are any of these helpful in preventing vap in your hospitals?

Not yet.

I heard that the Hi Lo Evac (continuous subglotic suction) is going to be combined with a silver lining.

And they missed a great opportunity to call it the.....

Hi Lo Silver!

We have used the Hi Lo hospital wide since 2004 and have reduced our VAP rate to an average of 1 per year (we are a 600 bed hospital with 32 ICU beds). I would love to see them combine the 2 tubes, we refuse to switch to the silver coated alone due to the cost and it doesn't address the consistent problem of having to suction manually the subglottic secretions and the stimulation of the gag reflex in awake patients prior to extubation.

The only things that have proven to reduce VAPs are due diligence of awareness and utilization of the bundles.

thank you all for the above input

OK, am I the only one to say it? Jeff, you are not right!

Very funny Jeff

I have to agree with Bill

The EVAC's can't but help in my thinking but there were several recomendations to the VAP study. I would suggest daily review of all the points of this study would reduce VAP's though none are definatively resultant in reductions.

I personally find the EVAC's frustrating due to the likelihood of clogging. A larger suction line would help. Silver, copper, line it with Gold or pokadot coloured strawberry flavoured uranium if you like.

There is actually a potential combination of several new things.

Imagine an ET tube with not only silver lining and a separate port for subglotic suction..but also...

A "Mucous Slurper" another port which goes to holes at the very bottom and sucks up gunk at the interface of trachea and very bottom of ET tube. This is actually being developed and/or studied.

A "Mucous Shaver" whereby periodically the innner ET tube has a retractable scraper inserted and then pulled out to remove the biofilm.....maybe a separate inline port for such and a place to dump the scrapings (good for compost for the garden).

And so two inline suction ports, a inline suction attachment and an inline scraper attachment (toggle between them).

Just go to PubMed and enter "Kolobow T" as author name. The "shaver" and "scraper" are being looked at.