Omneotech

In a non-intubated patients, natural defense mechanisms protect against the accumulation of airway secretions and the potentially harmful effects of bacteria present in those secretions.  Defense mechanisms such as glottic closure that assists with forceful coughing and the constant movement of microscopic cilia that line the trachea are immediately bypassed by the endotracheal tube when the patient is intubated.  The smooth-walled, synthetic endotracheal tube has no means by which to prevent the accumulation or eliminaion of secretions, mucus and bacterial biofilm. 

Airway mucus, bacterial biofilm and blood clots can lead to partical endotracheal tube occlusion, with difficulty in weaning from the ventilator (due to elevated 'imposed work of breathing') and also potentially contribute to the occurence or recurrence of ventilator-associated pneumonia (VAP).  Sudden obstruction of the endotracheal tube by mucus plugs can be life-threating, and typically results in emergent extubation or reintubation of the patient.