“We are hugely impressed with the direct benefits to patient safety through preventing avoidable harm and improving outcomes. We urge healthcare providers… to ensure the system is adopted. From a patient’s perspective, this is an opportunity that cannot be ignored.”
Trevor Fernandes, co-chair, East of England Citizens’ Senate

PneuX (1)Overview

The PneuX System is novel ventilation tube and cuff pressure monitor, which is designed to stop one ventilator-associated pneumonia (VAP), which is of the leading causes of death in intensive care units (ICU).

Using the PneuX system saves lives and has the potential to make significant cost savings for the NHS.

Each episode of VAP costs the NHS an additional £10,000 to £20,0001 and for the patient results in increased complications, length of mechanical ventilation, length of stay in the ICU and antibiotic use. VAP affects up to 20,000 patients each year, around a third of whom will die.

With standard leaky ventilation tubes, the cause of VAP is where bacteria contaminated secretions from the mouth and stomach leak into the patient’s lungs, leading to the potentially fatal pneumonia.

The PneuX system – unlike standard tubes – prevents leakage of the bacteria-laden secretions and protects the patient’s lungs and prevents VAP.

Numerous clinical and laboratory studies have shown that the PneuX system is the only ventilation tube that consistently prevents leakage of these secretions. A health economic evaluation by the University of Birmingham and the Royal College of Surgeons, based on an NHS England funded patient study at New Cross Hospital, showed that using the PneuX has a cost saving to the NHS of £718 for every patient.3

Challenge/problem identified

Ventilator-associated pneumonia (VAP) is the leading cause of infective hospital-acquired mortality in intensive care units, affecting up to per year in the UK. Almost a third (30%) of those affected will die, and each episode costs the NHS between £10,000 and £20,000.

The main cause of VAP is the use of standard leaky ventilation tubes, which allow the aspiration of bacteria contaminated secretions into the lungs. Bacterial contamination of the lungs usually occurs within 48 hours after intubation with an endotracheal tube or tracheostomy tube.

VAP increases length of time the patient is mechanically ventilated and their length of stay in the ICU, by around 28%, significantly adding to treatment costs.1 VAP increases antibiotic use: one study highlighted that 50% of all antibiotics used in the ICU are to treat VAP, and this can lead to multi-drug resistant bacteria, which is a global health problem.

Actions taken

The PneuX pneumonia prevention system has been designed to stop ventilator -associated pneumonia.

The device is a cuffed ventilation tube and an electronic cuff monitoring and inflating device (the tracheal seal monitor), that prevents leakage of bacteria contaminated secretions to the lung. The PneuX, unlike standard ventilation tubes, has a cuff that achieves an effective seal inside the patient’s trachea, which prevents leakage or aspiration of bacteria contaminates secretions into the lungs. It also has multiple drainage ports, to remove the secretions which sit above the cuff by suctioning these out through the subglottic ports; it is the only ventilation tube which allows irrigation and wash out of the airway above the cuff, to keep the oropharynx as clean as possible.

Peter Young, the innovator of the PneuX, has been using his time as an NHS Innovation Accelerator (NIA) Fellow to improve uptake of the device and promote it as a patient safety measure. He has done this by engaging a growing community of clinical champions, by influencing national leaders, through presentations at key conferences, by building the economic case and by attracting a national tariff for the PneuX.

Impacts/outcomes

PneuX (002)Several trials have demonstrated that the PneuX has substantial patient benefit and is highly cost saving for the NHS.

Numerous clinical and laboratory studies have shown that the PneuX system is the only ventilation tube that consistently prevents leakage of bacterial laden secretions into the lungs. A recent clinical study in high risk cardiac patients have found that the PneuX system was associated with a statistically significantly reduction in VAP compared with standard leaky ventilation tubes.

50% of all antibiotics used in the ICU are for the treatment of VAP. Clinical studies using the PneuX have showed 0% colonisation, 0% VAP and 0% antibiotic use over a 14 month study.

An independent health economic evaluation by the University of Birmingham and the Royal College of Surgeons, based on an NHS England funded patient study at New Cross Hospital, showed that using the PneuX has a cost saving to the NHS of £718 for every patient introduce into the ICU.3

The PneuX system has already received international interest and is currently being introduced into all of the ICUs at Massachusetts General Hospital, Boston, USA, with their leading critical care consultants, Professors Berra and Kacmarek.

Plans for the future

Peter has been working to improve uptake of the device in the UK and beyond.

PneuX meets the specification of the new 2017/18 NHS Innovation and Technology Tariff, and has been available to procure from 1 April 2017.

Peter has also had international interest in the innovation and is working with Massachusetts General Hospital in the US to implement the device there.

Which national clinical or policy priorities does this example address?

The NIC project sits within a context where better healthcare through improved hospital standards is a national priority. It also addresses NHSE priority areas including:

  • Funding and efficiency
  • Health and wellbeing
  • Care and quality.

Contact us for help and advice

Dr Peter Young, Consultant Critical Care, NIA Fellow
E: peteryoung101@googlemail.com
W: KLIPSuk.com
@klipsuk

Rebekah Tailor, Communications and Engagement Manager, NHS Innovation Accelerator
E: rebekah.tailor@uclpartners.com