Prevention of ventilator associated pneumonia (VAP)

{
  "publication_number": "US9457163B2",
  "country": "US",
  "kind": "B2",
  "title": "Prevention of ventilator associated pneumonia (VAP)",
  "abstract": "Ventilator associated pneumonia (VAP) may be prevented in a patient, or its occurrence reduced in a population of patients, by using an anti-VAP device or an anti-VAP material such as an anti-VAP mouthpiece that absorbs secretions. By reducing the problem of bacterial-containing secretions that otherwise build up in the airway of, and elsewhere in, the intubated patient, VAP can be prevented from occurring in intubated patients, such as patients intubated with an endotracheal tube (ETT) or a nasogastric tube. Anti-VAP mouthpieces also are useable in non-intubated patients to maintain oral hygiene.",
  "claims": [
    "1. A method adapted for preventing ventilator associated pneumonia (VAP) causing secretions from traveling into a lower respiratory tract of a patient, the method comprising: disposing a barrier in between a location of VAP-causing secretions and the lower respiratory tract of a patient, said barrier being a mouthpiece formed of an absorbent material and arranged at least partly in an oral cavity of said patient and wherein the mouthpiece comprises an upper segment formed of the absorbent material and a lower segment formed of the absorbent material; wherein disposing the barrier comprises (i) disposing the mouthpiece at least partly in said oral cavity of said patient, (ii) disposing the upper segment of the mouthpiece to cover upper dental and proximal mucosal surfaces of the oral cavity, and (iii) disposing the lower segment of the mouthpiece to cover lower dental and proximal mucosal surfaces of the oral cavity; and absorbing VAP-causing secretions with said absorbent material of said mouthpiece, wherein said VAP-causing secretions are blocked from passing said barrier into the lower respiratory tract of said patient without obstructing a center pharyngeal lumen of said patient, wherein said location of VAP-causing secretions includes at least said oral cavity.",
    "2. The method of claim 1, wherein said absorbent material is saturated with antimicrobials or other medicinals for sustained contact and release to at least one dentition or mucosal surface of said patient.",
    "3. The method of claim 1, wherein said upper segment and said lower segment together form a solid member which is a one-size-fits-all shape installable in adult patients irrespective of tracheal diameter.",
    "4. The method of claim 1, wherein said upper segment and said lower segment together form a solid member which is a one-size-fits-all shape installable in pediatric patients irrespective of tracheal diameter.",
    "5. The method of claim 1, further comprising saturating the absorbent material with medicinals or antimicrobials.",
    "6. The method of claim 1, further comprising non-surgically removing said barrier from said patient.",
    "7. The method of claim 1, wherein said absorbent material is saturated with antimicrobials, and said antimicrobials are selected from the group consisting of chlorhexidine and hydrogen peroxide.",
    "8. The method of claim 5, further comprising resaturating said absorbent material with medicinals or antimicrobials.",
    "9. The method of claim 1, wherein said lower segment is configured to cover at least part of lower dentition and gingival of said patient.",
    "10. The method of claim 1, wherein said lower segment includes a lower plate configured to cover a tongue of said patient.",
    "11. The method of claim 1, wherein said upper segment is configured to cover at least part of upper dentition and gingival of said patient.",
    "12. The method of claim 1, wherein said upper segment includes an upper plate configured to cover a hard/soft palate surface of said patient.",
    "13. The method of claim 1, further comprising side wings configured to cover buccal mucosa of said patient.",
    "14. The method of claim 13, wherein said side wings are comprised at least partly of absorbent material.",
    "15. The method of claim 1, further comprising passing an endotrachial tube (ETT) or a nasogastric tube through a center-hole in said barrier for intubation of said patient.",
    "16. The method of claim 1, wherein said disposing said barrier and absorbing said VAP-causing secretions are performed in the absence of suction of said VAP-causing secretions.",
    "17. The method of claim 13, wherein the side wings have a first segment extending upwardly to cover an upper dental and mucosal region and a second segment extend downwardly to cover a lower dental and mucosal region."
  ],
  "description_excerpt": "This invention relates to treatment of patients who are intubated with an endotracheal tube (ETT), and especially to ventilator associated pneumonia (VAP) undesirably associated with such intubation.\n\nVentilator associated pneumonia (VAP) is a potentially preventable cause of pneumonia that occurs in patients who are endotracheally intubated and mechanically ventilated for more than 48 hours. VAP may occur in up to 65% of patients in the intensive care unit (ICU) and is associated with an increase in morbidity and mortality. It is estimated that cost of diagnosing and treating VAP exceeds 1.1 billion dollars annually. Young P J, Ridley S A, Ventilator-associated pneumonia, Diagnosis, pathogenesis and prevention, Anaesthesia 1999; 54(12):1183-97; Morehead R S, Pinto S J, Ventilator-associated pneumonia, Arch Intern Med 2000; 160(13):1926-36.\n\nVAP is usually a bacterial nosocomial pneumonia, which was neither present nor incubating at the time of endotracheal intubation. Causes of VAP are multifactorial (FIG. 1). The diagnosis of VAP is difficult and expensive. Controversy continues to exists in the methodology in making a definitive diagnosis. Treatment is also controversial and the use of empiric antibiotics is believed to have contributed to making the overall treatment of true VAP more difficult. Patients developing VAP require additional testing to make the diagnosis and additional treatments. A major cost to the treatment is prolonging the time patients require mechanical ventilation and thus care in the ICU setting.",
  "cpc": [
    "A61M 16/0434",
    "A61M 16/04",
    "A61M 16/0436",
    "A61M 16/0479",
    "A61M 16/049",
    "A61M 2205/0205"
  ],
  "ipc": [
    "A61M 16/00",
    "A61M 16/04"
  ],
  "assignees": [
    "Virginia Commonwealth University"
  ],
  "inventors": [
    "Kevin R. Ward",
    "Curtis N. Sessler",
    "Mary Jo Grap",
    "Laurence J. Dinardo",
    "Bruce D. Spiess",
    "Rao R. Ivatury",
    "Cindy Muare"
  ],
  "filing_date": "2011-07-13",
  "publication_date": "2016-10-04",
  "grant_date": "2016-10-04",
  "priority_date": "2004-09-03",
  "application_number": "US-201113181843-A",
  "family_id": "45437679",
  "cited_by_count": 4,
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}