The Use of the EndoClear Catheter Device to Improve Ventilator Weaning

Purpose:
Routine suctioning doesn't remove adherent secretions on the ET, resulting in a narrowed airway and increased work of breathing. The purpose of this study is to compare the effectiveness of the EndOclear catheter in removing adherent secretions prior to weaning trials compared to routine suctioning.

Significance:
Caring for ventilated patients in ICU is more expensive than caring for non-ventilated patients. Standard suctioning does not remove adherent secretions. An endotracheal tube clearing device, EndOclear, removes adherent secretions and restores the ET tube to optimal weaning conditions.

Strategy and Implementation:
Partial occlusion or narrowing of the endotracheal tube has been associated with increased patient work of breathing and delayed extubation. Extubated endotracheal tubes often demonstrate an increased airway resistance and work of breathing equivalent to a one size smaller tube endotracheal tube obstruction An endotracheal tube clearing device, EndOclear, removes adherent secretions and restores the ET tube to optimal weaning conditions. This is a two year retrospective study of all adult patients, age 18 or older, admitted the Intensive Care Unit who were on the ventilator greater than 24 hours, and who meet the general criteria for the sedation awakening and weaning trials. 2011 ventilator days, ICU length of stay (LOS), hospital LOS, and VAP was compared with 2012 patients who had their endotracheal tubes cleared with the EndoClear catheter prior to the weaning trial.

Evaluation:
1112 cases were reviewed between 2011 and 2012. After initiation of the EndOclear tube there was a decrease in ventilator days, ICU LOS, and the hospital LOS. There was an estimated direct cost savings of $536,710 in 2012 with the use of the EndOclear catheter prior to weaning trials.

Implications for Practice:
Utilizing the EndOclear catheter prior to weaning trials is a safer, more effective way to remove adherent secretions on the endotracheal tube then routine suctioning technique resulting in better patient care outcomes and provides a costs savings to the hospital.