The Research And Development Of The Antibacterial Coating Endotracheal Tube With Silver Loaded Titanium Dioxide

Object In order to prevent endotracheal intubation catheter-induced respiratory infection ventilator-associated pneumonia (VAP), we prepared the antibacterial coating endotracheal tube (ETT) with silver loaded titanium dioxide, analysed the characterization and the antibacterial property, and studied on adverse bioreaction.Methods Useing the medical polyethylene ETT as the fundamental catheter, titanium dioxide with silver as the antibacterial agent, TEOS as the silicon source and KH570、MTES as the organic phase precursor, we prepared TEOS/KH570/MTES/Ag-TiO2antibacterial coating ETT with silver loaded titanium dioxide by the sol-gel method. Then we analysed the characterization of the antibacterial coating by sol stability test, coating hardness and adhesion test IR analysis of the coating, the coating surface morphology analysis, translucent coating test and ICP-MS test, and determined the composition proportion of the antibacterial coating. We selected standard Pseudomonas aeruginosa liquids, standard Escherichia coli liquids and standard Staphylococcus aureus liquids to carry out antibacterial property test of the antibacterial coating ETT with silver loaded titanium dioxide by impregnated bacterial liquid incubation method. In order to ensure adverse bioreactions of the antibacterial coating ETT with silver loaded titanium dioxide,we carried out oral mucous irritation test, pyrogen test, hemolysis test and toxicity test to determine biocompatibility and biological safet.Results TEOS/KH570/MTES/Ag-TiO2=15/6/1/≤1.0antibacterial sol coated on the polyethylene ETT had an excellent adhesion (level0), suitable surface hardness (5H) and the sol stability, which showed that antibacterial sol coating adhered closely with polyethylene ETT surface, ensured that antibacterial ETT was flexible, stable and unbreakable, and that antibacterial sol coating was uniform and stable. IR analysis showed that TEOS/KH570/MTES/Ag-TiO2=15/6/1/1.0antibacterial coating had sufficient crosslinking reaction, and that the coating compositions had formed a whole, not easy to fall off. The antibacterial sol coating surface morphology under scanning electron microscopy showed smooth, no small particles and no any phase separation phenomenon, the network structure was compact, stable without separation, which explained the coating ETT surface was very smooth. UV-Vis spectrophotometer test showed that the average transmittance of the translucent was>90%and the antibacterial coating could improve anti-reflection of ETT. ICP-MS test of silver ion release showed that the silver ion release was almost negligible, which explained the antibacterial coating ETT had excellent antibacterial property and stability. The antibacterial property test showed that antibacterial coating ETT with silver loaded titanium dioxide could kill bacterias such as Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus. Its antibacterial property was excellent and relative to the antibacterial concentration. The higher of the antibacterial concentration of silver loaded titanium dioxide was used, the stronger the antibacterial property were shown. And above1%antibacterial concentration, tubes had shown the strong antibacterial effects, almost completely sterilized bacterias in the immersing liquid. The oral mucous irritation test showed that the extracts of the coating ETT was no irritation reactions to golden hamsters oral mucous. The pyrogen test showed that the maximum elevated temperature of the rabbits within3.0h time point after injected the extracts of the coating_ETT were respectively0℃,0℃and0.03℃, the total elevated temperature was0.3℃. The hemolysis test showed that the absorbances of the coating ETT were:0.016,0.014,0.021, average of0.0170, and the calculated hemolysis rate was0.7512%. The acute systemic toxicity testshowed that the coating ETT extracts were no animal died in the whole process of the experiment, and no abnormal reaction. The vitro cytotoxicity test showed that adherent growth of morphology normal cell was good, discrete particles in the cytoplasm of no cell lysis, determinated non-toxic and toxicity grade0, while the relative cell proliferation rate was more than100%.Conclusion we determine the proportion of TEOS/KH570/MTES/Ag-TiO2=15/6/1/<1.0and the concentration of1%silver loaded titanium and dioxide to prepare the antibacterial coating ETT with silver loaded titanium dioxide which had good characterization, excellent antibacterial property and satisfy biocompatibility and biological safet. The antibacterial coating ETT could be used to Preclinical study.