Background. Paediatric tracheostomy is performed as an adjunct to long-term ventilation or to relieve airway obstruction, particularly in infants. Respiratory complications are common, resulting in morbidity, mortality, and excess healthcare costs. Contributing mechanisms likely include biofilms on PVC, silicone or polyurethane tube surfaces, which are often scaled-down versions of adult designs posing unique challenges due to smaller airway calibres and ongoing growth. Recent advances in biomaterial additives manufacturing provide an opportunity to design a paediatric-specific tracheostomy tube with increased cytocompatibility and biofilm-resistance.
Methods. We have a systematic review paper in preparation, identifying 3-5 biomaterial additives with promising mechanical and immunological properties to function optimally as a tracheostomy tube coating. Prototypes will be designed and 3D-printed using biomedical CAD/CAM and stress tested to ensure durability when exposed to the warm and humid conditions of the trachea, led by Jenny Olsen (School of Engineering, Newcastle University) who brings expertise in medical devices. Further immunological testing supervised by Jason Powell (MRC Clinician Scientist and Consultant Paediatric ENT Surgeon) will assess biofilm resistance after bacterial culture exposure and cytocompatibility using an air-liquid interface (ALI) culture taken from primary paediatric epithelial cells (biobanked within the Powell research group), to build performance profiles compared to current products. The 1-2 best designs for an optimised, next-generation paediatric tracheostomy tube will be taken forward for onward research.
Intended use. £500 would be used for 3D-printing costs, £500 for plasticware and media associated with the ALI airway epithelial culture, and £500 for in vitro assays and other consumables.