Novel system for complete removal of secretions within the endotracheal tube: the Mucus Shaver.

THE method normally used to clean endotracheal tubes (ETTs) in intubated patients is via a small, flexible, plastic suction catheter. The small-bore tube is inserted into the ETT and manipulated to remove mucus lodged within the ETT and this process is repeated as frequently as indicated. This may not remove all secretions. With residual secretions retained on the surface, the ETT provides a fertile ground for bacterial proliferation and biofilm formation. Bacteria-laden biofilm promotes bacterial colonization of the lower respiratory tract and development of ventilator-associated pneumonia. Moreover, any mucus accumulated within the ETT decreases its internal diameter, increasing resistance to airflow and work of breathing. To overcome this problem, we devised the Mucus Shaver (National Institutes of Health, Bethesda, Maryland).‡ In one sweep, the Mucus Shaver removes all mucus from the lumen of the ETT, restoring the appearance of the lumen to that of a new, unused ETT.