Studies Find Nellcor's Hi-Lo Evac Endotracheal Tube Significantly Reduces Ventilator-Associated Pneumonia Rates


PLEASANTON, Calif. -- Nellcor, part of Tyco

Healthcare, today announced that two studies presented at the American

Association for Respiratory Care (AARC)'s 49th Annual International Respiratory

Congress, held in December 2003, found the Mallinckrodt-brand

Hi-Lo Evac Endotracheal Tube from Nellcor greatly reduced rates of

ventilator-associated pneumonia (VAP).

VAP refers to nosocomial pneumonia that develops in mechanically

ventilated patients (1). It is recognized to be one of the most serious and

costly hospital-acquired infections. One case of VAP can result in more than

$40,000 in additional hospital costs (2). In the United States, VAP is

estimated to result in $1.5 billion in excess expenditures and 1.75 million

additional hospital days each year (3).

One way to reduce episodes of VAP is through the continuous aspiration of

subglottic secretions, which is facilitated by the Hi-Lo Evac Endotracheal

Tube. Researchers from Sentara Healthcare in Virginia Beach, Va., conducted a

study to determine how using the Hi-Lo Evac Endotracheal Tube in place of

conventional ET tubes would impact VAP rates in a community-based general

intensive care unit (ICU).

Compared with the previous year, use of the Hi-Lo Evac Endotracheal Tube

resulted in a 52 percent decrease in VAP rates. This study was consistent with

controlled studies reporting a 40 percent to 50 percent reduction in VAP rates. Sentara

Healthcare now uses the Hi-Lo Evac Endotracheal Tube as a standard of care in

its ER, ICUs and crash carts.

"We believe the Hi-Lo Evac Endotracheal Tube is an important component in

our efforts to promote patient safety," said Paul Garbarini, MS, RRT, Sentara

Healthcare. "The Agency for Healthcare Research and Quality's 'Making Health

Care Safer: A Critical Analysis of Patient Safety Practices' listed continuous

aspiration of subglottic secretions in its highest recommendations for Patient

Safety Practices. We have since expanded Hi-Lo Evac therapy to a second

hospital and achieved similar results."

Researchers from Deborah Heart and Lung Center in Browns Mills, N.J.,

conducted a study to evaluate the Hi-Lo Evac Endotracheal Tube as an adjunct

in managing VAP. During a three-month period, all patients at Deborah Heart

and Lung Center were intubated with the Hi-Lo Evac Endotracheal Tube.

Patients transferred from other facilities and those in the ICU who were

already intubated were exempted.

During the study period, the VAP rate at Deborah Heart and Lung Center

dropped below the national average of 10.5 incidence/1,000 days. The

researchers are now collecting data for a one-year period and will reevaluate

the results.

"The Hi-Lo Evac Endotracheal Tube from Nellcor has been an important asset

in combating VAPs," said John J. Hill, RRT, Deborah Heart and Lung Center.

"This strategy has enabled our patients to be at ease with lowered infection

rate outcomes. We are proud to be including this device with all our surgical


With its integral suction lumen, the Hi-Lo Evac Endotracheal Tube is designed to provide

a safe, convenient way to remove secretions above the endotracheal tube cuff.

Using theHi-Lo Evac Endotracheal Tube in place of standard endotracheal tubes

can help decrease the occurrence of VAP, which may lead to reduced costs and

improved outcomes.

Nellcor is dedicated to developing innovative, clinically relevant medical

products with an emphasis on noninvasive patient safety monitoring and

respiratory care. A part of Tyco Healthcare, Nellcor is the world's foremost

supplier of pulse oximetry and airway management products. The company also

offers a wide range of products for measuring and regulating patient body


Tyco Healthcare, a major business segment of Tyco International Ltd., is a

leading manufacturer, distributor and servicer of medical devices worldwide.

Its broad portfolio includes disposable medical supplies, monitoring

equipment, medical instruments and bulk analgesic pharmaceuticals, sold under

such names as Auto Suture, Kendall, Mallinckrodt, Nellcor, Puritan Bennett,

United States Surgical, Valleylab and others.


(1) Kollef MD, Marin H. The prevention of ventilator-associated pneumonia.

The New England Journal of Medicine. February 1999.

(2) Rello J, Ollendorf DA, et al. Epidemiology and outcomes of

ventilator-associated pneumonia in a large U.S. database. Chest.


(3) Wilbin R. Nosocomial Pneumonia, Prevention and Control of Nosocomial

Infections. Williams and Wilkins, 1997.

Source: Nellcor

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