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Marcos I. Restrepo, MD, FCCP; Juan F. Fernandez, MD; Stephanie M. Levine, MD, FCCP
Author and Funding Information

From the Department of Medicine (Drs Fernandez, Levine, and Restrepo), Division of Pulmonary and Critical Care Medicine, the University of Texas Health Science Center at San Antonio; and the Veterans Evidence Based Research Dissemination and Implementation Center (VERDICT) (Dr Restrepo), Audie L. Murphy VA Hospital.

Correspondence to: Marcos I. Restrepo, MD, FCCP, University of Texas Health Science Center, 7400 Merton Minter Blvd, San Antonio, TX 78229; e-mail: restrepom@uthscsa.edu

From the Department of Medicine (Drs Fernandez, Levine, and Restrepo), Division of Pulmonary and Critical Care Medicine, the University of Texas Health Science Center at San Antonio; and the Veterans Evidence Based Research Dissemination and Implementation Center (VERDICT) (Dr Restrepo), Audie L. Murphy VA Hospital.

Correspondence to: Marcos I. Restrepo, MD, FCCP, University of Texas Health Science Center, 7400 Merton Minter Blvd, San Antonio, TX 78229; e-mail: restrepom@uthscsa.edu

From the Department of Medicine (Drs Fernandez, Levine, and Restrepo), Division of Pulmonary and Critical Care Medicine, the University of Texas Health Science Center at San Antonio; and the Veterans Evidence Based Research Dissemination and Implementation Center (VERDICT) (Dr Restrepo), Audie L. Murphy VA Hospital.

Correspondence to: Marcos I. Restrepo, MD, FCCP, University of Texas Health Science Center, 7400 Merton Minter Blvd, San Antonio, TX 78229; e-mail: restrepom@uthscsa.edu


Funding/Support: Dr Restrepo is partially funded by the National Heart, Lung, and Blood Institute [K23HL096054].

Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Restrepo is a former participant in advisory boards for Theravance Inc; Forest Laboratories, Inc; Johnson & Johnson Services, Inc; Trius Therapeutics; and Novartis AG and has been a consultant for Theravance Inc; Trius Therapeutics; and Pfizer, Inc. Drs Fernandez and Levine have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(5):1359. doi:10.1378/chest.12-1927
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Thank you, Dr Poelaert, for your comments and your interest in our article.1 We carefully reviewed your study again for a detailed explanation of the methods used.2 As stated in your publication, “Patients scheduled for cardiac surgery were randomly assigned to receive polyurethane (PU) (Sealguard; Covidien, Mansfield, MA) or a standard polyvinyl chloride (PVC; Mallinckrodt Inc, Hazelwood, MO), high volume, low-pressure cuffed endotracheal tube (ETT) at induction of anesthesia.”2 Your correspondence on our article suggests that the Sealguard ETT used in your study was a barrel-shaped polyurethane cuffed ETT, which is different from the tapered-shaped polyurethane product featured on the company’s website using the specific trademarked name described in your study, accessed by us in spring 2011 and reconfirmed at the time of this writing in July 2012.3 In addition, the online product description references the ETT studied by Lorente et al4,5 as a tapered PU cuff as well. The specific description of the shape of the ETT is not actually found in either your article2 or that of Lorente et al,4 suggesting an important limitation of the current literature. Future studies should describe in detail not only the material of the ETT and cuff but also the shape of the cuff. Therefore, we believe our review was correct based on the information that was available to us at the time of writing the article.

Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or in the preparation of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health.

Fernandez JF, Levine SM, Restrepo MI. Technologic advances in endotracheal tubes for prevention of ventilator-associated pneumonia. Chest. 2012;142(1):231-238. [CrossRef] [PubMed]
 
Poelaert J, Depuydt P, De Wolf A, Van de Velde S, Herck I, Blot S. Polyurethane cuffed endotracheal tubes to prevent early postoperative pneumonia after cardiac surgery: a pilot study. J Thorac Cardiovasc Surg. 2008;135(4):771-776. [CrossRef] [PubMed]
 
Mallinckrodt “SealGuard” endotracheal tube. Covidien website.http://www.nellcor.com/prod/Product.aspx?S1=AIR&S2=&id=325/. Accessed July 25, 2012.
 
Lorente L, Lecuona M, Jiménez A, Mora ML, Sierra A. Influence of an endotracheal tube with polyurethane cuff and subglottic secretion drainage on pneumonia. Am J Respir Crit Care Med. 2007;176(11):1079-1083. [CrossRef] [PubMed]
 
Mallinckrodt Sealguard Evac endotracheal tube. Covidien website.http://www.covidien.com/imageServer.aspx/doc 225437.pdf?contentID=24182&contenttype=application/pdf. Accessed July 25, 2012.
 

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References

Fernandez JF, Levine SM, Restrepo MI. Technologic advances in endotracheal tubes for prevention of ventilator-associated pneumonia. Chest. 2012;142(1):231-238. [CrossRef] [PubMed]
 
Poelaert J, Depuydt P, De Wolf A, Van de Velde S, Herck I, Blot S. Polyurethane cuffed endotracheal tubes to prevent early postoperative pneumonia after cardiac surgery: a pilot study. J Thorac Cardiovasc Surg. 2008;135(4):771-776. [CrossRef] [PubMed]
 
Mallinckrodt “SealGuard” endotracheal tube. Covidien website.http://www.nellcor.com/prod/Product.aspx?S1=AIR&S2=&id=325/. Accessed July 25, 2012.
 
Lorente L, Lecuona M, Jiménez A, Mora ML, Sierra A. Influence of an endotracheal tube with polyurethane cuff and subglottic secretion drainage on pneumonia. Am J Respir Crit Care Med. 2007;176(11):1079-1083. [CrossRef] [PubMed]
 
Mallinckrodt Sealguard Evac endotracheal tube. Covidien website.http://www.covidien.com/imageServer.aspx/doc 225437.pdf?contentID=24182&contenttype=application/pdf. Accessed July 25, 2012.
 
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