A Mechanically Ventilated Model for Pediatric and Neonatal

1
A Mechanically Ventilated Model for Pediatric and
Neonatal Intensive Care Unit (PICU) (NICU)
PatientsCovidien and Biofilm Research Laboratory

• VAP (Ventilator-associated pneumonia) is the
  second most common hospital-acquired infection
  among pediatric and neonatal intensive care unit
  (PICU) (NICU) patients.
• In the United States
• 516,000 infants are admitted to NICUs.
• 258,000 infants require mechanical ventilation.
• 3-10 of ventilated pediatric ICU (NICU and PICU)
  patients acquire VAP.
• Of which, have a mortality rate of 20.
• 6.8-32.3 of NICU patients with acquired
  nosocomial infections have pneumonia.
• VAP is associated with
• Increased morbidity in NICU and PICU patients.
• Longer duration of mechanical ventilation.
• Increased resource utilization, specifically
  antibiotic administration.
• Increased hospital costs (2yr. study of PICU
  patients).
• Patients with VAP 38,614.
• Patients without VAP 7,682 .
• Increased ICU resources devoted to caring for
  NICU and PICU patients.
• Roughly 50 of resources such as empirical
  antibiotics.
• Due to the severity of the development of VAP in
  the NICU and PICU, it is urgent to develop new
  technology to prevent this and reduce any
  potential HAI or nosocomial infections.

Prepared by Christopher L. Waters, MS John G.
Thomas, PhD
2
Comparative Characteristics for NICU vs. PICU at
WVUH
Prepared by Christopher L. Waters, MS John G.
Thomas, PhD
3
VENT PROFILES
ZONE X
Prepared by Christopher L. Waters, MS John G.
Thomas, PhD
4
SHEAR FORCES
Prepared by Christopher L. Waters, MS John G.
Thomas, PhD
5
FIVE CLINICAL ISOLATES
ZONE Y
Strategy Early/Late
Inoculum/ Nebulizer
2-5 micron drops Continuous
Prepared by Christopher L. Waters, MS John G.
Thomas, PhD
6
ZONE Z

• Covidien (Infransonic) Neonatal Lung (1 liter)
  with modified cap.
• Neonatal and Pediatric lung function
  (Non-Compliant).
• Designed to mix gases and maintain exchange.
• Contents include
• Marbles.
• Sheared copper wool (shown).
• Purpose of contents intended to take up volume.

Prepared by Christopher L. Waters, MS John G.
Thomas, PhD
7
Complex Biofilm Development in a Closed Neonatal
Model
Zone Z
Zone Y
Zone X
Biofilm Development in a Five Part Closed
Ventilation Endotrach Model
A. Puritan-Bennett 840 Ventilator with adjustable
parameters Volume Pressure Flow FIO2
B. Antimicrobial Intervention
Proximal Flow Sensor
Culture Trap (waste)

VAP Cocktail

E. Covidien Test Lung Simulator with 1.
non-compliance
C. Endotrach Tubing Undisturbed
Luminal Biofilm
D. Inoculation Nebulizer with Sentinal
Organisms 1. Media 2. One isolate
vs. multiple organisms
Shown is 1 of 6 Stations Simulating a
Multi-patient Intensive Care Unit
Prepared by Christopher L. Waters, MS John G.
Thomas, PhD