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  • 1.
    Backman, Sara
    et al.
    School of Chemical Science and Engineering, Fiber, and Polymer Technology, Royal Institute of Technology (KTH), Stockholm.
    Björling, Gunilla
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Anaesthesia and Intensive Care, Stockholm.
    Johansson, Unn-Britt
    Sophiahemmet University College, Stockholm.
    Lysdahl, Michael
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Anaesthesia and Intensive Care, Stockholm.
    Markström, Agneta
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Anaesthesia and Intensive Care, Stockholm.
    Schedin, Ulla
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Anaesthesia and Intensive Care, Stockholm.
    Aune, Ragnhild E
    School of Industrial Technology and Management, Materials Science and Engineering, Royal Institute of Technology (KTH), Stockholm.
    Frostell, Claes
    Karolinska Institutet, Department of Anesthesia, Surgical Services and Intensive Care, Karolinska University Hospital, Stockhol.
    Karlsson, Sigbritt
    School of Chemical Science and Engineering, Fiber, and Polymer Technology, Royal Institute of Technology (KTH), Stockholm.
    Material wear of polymeric tracheostomy tubes: A six-month study2009In: The Laryngoscope, ISSN 0023-852X, E-ISSN 1531-4995, Vol. 119, no 4, p. 657-664Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objectives were to study long-term material wear of tracheostomy tubes made of silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU) after 3 and 6 months of clinical use.

    STUDY DESIGN: The study has a prospective and comparative design.

    METHODS: Nineteen patients with long-term tracheostomy, attending the National Respiratory Center in Sweden, were included, n = 6 with Si tubes, n = 8 with PVC tubes, and n = 5 with PU tubes. The tubes were exposed to the local environment in the trachea for 3 and 6 months and analyzed by scanning electron microscopy, attenuated total reflectance Fourier transform infrared spectroscopy, and differential scanning calorimetry.

    RESULTS: All tubes revealed severe surface changes. No significant differences were established after 3 or 6 months of exposure between the various materials. The changes had progressed significantly after this period, compared to previously reported changes after 30 days of exposure. The results from all analyzing techniques correlated well.

    CONCLUSIONS: All tubes, exposed in the trachea for 3-6 months, revealed major degradation and changes in the surface of the material. Polymeric tracheostomy tubes should be changed before the end of 3 months of clinical use.

  • 2.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Material Wear of Medical Technical Products: Impact on patient safety2018Conference paper (Refereed)
    Abstract [en]

    The use of a central venous catheters (CVC) always involves an increased risk of infection and thrombotic complications, subsequently increasing patient suffering, prolonged care and health care related costs. One contributing cause of infection is that the surface of the catheter is quickly colonized by bacteria, forming a biofilm, hard to reach by and/or resistant to antibiotics and the patient’s immune defense system. Catheter related thrombosis may also promote colonization of microbes on the fibrin sheet at the surface, and at the same time impact on CVC functionality by lumen occlusion or, in a rare worst-case scenario – cause life threatening embolic events. Coatings with silver or metal alloys can reduce the risk for complications. Our research group have previously identified a correlation between material degradation in medical devices used in patients and exposure time and infections. This talk will discuss the impact of material degradation of different types of CVCs used for patients undergoing chemotherapy against breast cancer.  The results from an evaluation study of a anti infectious noble metal alloy coated CVC compared with an uncoated CVC for tolerability (Adverse Events, AEs), performance and noble metal durability on the surface will also be discussed.

  • 3.
    Björling, Gunilla
    et al.
    Department of Clinical Sciences, Division of Anaesthesia and Intensive Care, Karolinska Institutet, Danderyd Hospital, National Respiratory Centre, Stockholm.
    Axelsson, Sara
    School of Chemical Science and Engineering, Fibre and Polymer Technology, Royal Institute of Technology (KTH), Stockholm.
    Johansson, Unn-Britt
    Sophiahemmet University College, Stockholm.
    Lysdahl, Michael
    Department of Clinical Sciences, Division of Anaesthesia and Intensive Care, Karolinska Institutet, Danderyd Hospital, National Respiratory Centre, Stockholm.
    Markström, Agneta
    Department of Clinical Sciences, Division of Anaesthesia and Intensive Care, Karolinska Institutet, Danderyd Hospital, National Respiratory Centre, Stockholm.
    Schedin, Ulla
    Department of Clinical Sciences, Division of Anaesthesia and Intensive Care, Karolinska Institutet, Danderyd Hospital, National Respiratory Centre, Stockholm.
    Aune, Ragnhild E
    School of Industrial Technology and Management, Materials Science and Engineering, Royal Institute of Technology (KTH), Stockholm.
    Frostell, Claes
    Department of Anaesthesiology and Intensive Care Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm.
    Karlsson, Sigbritt
    School of Chemical Science and Engineering, Fibre and Polymer Technology, Royal Institute of Technology (KTH), Stockholm.
    Clinical use and material wear of polymeric tracheostomy tubes2007In: The Laryngoscope, ISSN 0023-852X, E-ISSN 1531-4995, Vol. 117, no 9, p. 1552-1559Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objectives were to compare the duration of use of polymeric tracheostomy tubes, i.e., silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU), and to determine whether surface changes in the materials could be observed after 30 days of patient use.

    METHODS: Data were collected from patient and technical records for all tracheostomized patients attending the National Respiratory Center in Sweden. In the surface study, 19 patients with long-term tracheostomy were included: six with Bivona TTS Si tubes, eight with Shiley PVC tubes, and five with Trachoe Twist PU tubes. All tubes were exposed in the trachea for 30 days before being analyzed by scanning electron microscopy (SEM) and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR). New tubes and tubes exposed in phosphate-buffered saline were used as reference. RESULTS: Si tubes are used for longer periods of time than those made of PVC (P<.0001) and PU (P=.021). In general, all polymeric tubes were used longer than the recommended 30-day period. Eighteen of the 19 tubes exposed in patients demonstrated, in one or more areas of the tube, evident surface changes. The morphologic changes identified by SEM correlate well with the results obtained by ATR-FTIR.

    CONCLUSIONS: Si tracheostomy tubes are in general used longer than those made of PVC and PU. Most of the tubes exposed in the trachea for 30 days suffered evident surface changes, with degradation of the polymeric chains as a result.

  • 4.
    Fossum, Maren
    et al.
    Norwegian University of Science and Technology, Trondheim, Norway.
    Tunc, Zozan
    KTH.
    Strömberg, Emma
    KTH.
    Frostell, Claes
    Karolinska Institutet.
    Liljegren, Annelie
    Karolinska Institutet.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Aune, Ragnhild
    Norwegian University of Science and Technology, Trondheim, Norway.
    In-vitro and In-vivo Exposure of Intravascular Catheters to Cytostatic Drugs2018Conference paper (Refereed)
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