Detecting Ventilator Associated Pneumonia Through On-board Endotracheal Tube Diagnostics

Ventilator-associated pneumonia (VAP) is a burdensome healthcare-associated infection which puts 54% of intensive care unit (ICU) life support patients across the United States at serious risk. Half of all antibiotics in the ICU are prescribed for VAP, but due to widespread inadequate treatment (up to 30% of cases), mortality rates remain as high as 24-76%. Inadequate treatment stems from lack of diagnostic and monitoring capacity. The current standard of detection is a non-specific complete blood count (CBC) completed every 24 hours. CBCs may take up to an additional 24 hours to process, allowing the infection to grow and become more difficult to treat for a total of 48 hours. To address these issues, this study conceptualizes a passively operated, high-fidelity, and high-frequency bacterial monitoring device to detect the presence and concentrations of bacteria commonly encountered in VAP. Electrochemical Impedance Spectroscopy (EIS) has been utilized extensively in electrochemical industry applications such as acid battery testing and, more recently, as a sensitive method for biofouling quantification. However, EIS has not been implemented clinically. The selected design will use a specialized EIS sensor to analyze mucosal excretions of intubated patients and quantify the bacteria present. This technology can alert physicians of infection 24-48 hours earlier than currently possible, allowing patients to receive treatment faster and thus potentially reducing their length of stay (LOS) in the ICU by ~6 days. Our findings project that this approach would lower each VAP patient’s treatment cost by approximately $24,000 and would save healthcare systems $3,600 per ICU patient (rates and estimates determined in 2019).