Upper airway host defences - ENT volunteers
Research type
Research Study
Full title
Modulation of the upper airway host defences to prevent pneumonia in ventilated patients - ENT volunteers
Contact name
Janet Wilson
Contact email
Sponsor organisation
Newcastle upon Tyne Hospital NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Critically ill patients in intensive care units (ICUs) often require help with their breathing. This involves placing a plastic tube between the vocal cords of the unconscious patient, and into the windpipe, after which the tube is attached to a ventilator machine. The tube is kept in place by inflating a balloon (or "cuff") at the end of the tube, to hold the tube against the windpipe, just below the vocal cords. In health, the vocal cords and a normal cough prevent germs entering the lung. Sadly, the combination of critical illness, reduced cough, and having a tube specifically "bypassing" the vocal cords, leaves these patients extremely vulnerable to lung infection. So, precisely when they are least able to tolerate new hospital infections, critically ill patients are most vulnerable to a lung infection termed "ventilator-acquired pneumonia" (VAP). This infection causes more deaths than any other hospital-acquired infection. New ways to prevent it, preferably without using antibiotics, are urgently required. A key starting point would be identifying how germs begin their journey into the lung. We know germs rapidly grow just above the cuff of the tube in the voice box (an area known as the "subglottis"), before passing into the lung. However, understanding how germs rapidly establish "colonies" in this region, and evade the immune system, is hampered by a lack of cells from the human subglottis, for study in the lab.
From our previous research study that is near completion, we have been able to successfully culture primary subglottic epithelial cells, from atraumatic brushings in ENT theatre patients. We would like to expand on this proof of concept study by moving on to sample a pilot group of 30 patients in the same manor to investigate a number of novel ways of preventing infection using this relevant tissue.
REC name
West Midlands - Edgbaston Research Ethics Committee
REC reference
15/WM/0349
Date of REC Opinion
18 Sep 2015
REC opinion
Favourable Opinion