Effects of endotracheal tube selection on flow behavior to prevent ventilator-associated pneumonia

Ventilator-associated pneumonia (VAP) is a common secondary infection developed from longterm use of mechanical ventilators. The accumulation of mucus around the endotracheal tube (ETT), placed in the upper trachea of an intubated patient, leads to bacterial colonization which is the cause of such secondary infections. Considerable factors affect the mucus pooling along the ETT including the interactions between mucus and airflow, selection of ETT (size and cuff shape), and ventilator cycling. A quantitative understanding of the relationships between these different factors can be obtained from well-resolved simulations of the flow through the upper trachea. The present study focuses on the effect of the ETT on the mucus pooling behavior in an intubated trachea. Large Eddy Simulations of a Weibel-based model are implemented with two different endotracheal cuffs to determine the interaction of the cuff shape with the airflow rates and mucus pathways. This research further employs commonly used ventilator cycles to demonstrate the role of resulting flow patterns in long-term mucus deposition and release. Studying the flow surrounding the ETT will result in a better understanding of the flow behavior of intubated patients to reduce secondary infection.