July 7, 2009 — One of the greatest risks for critically ill children on a ventilator is developing ventilator-associated pneumonia. The infection, caused by an accumulation of infected fluid that gets trapped between the intubation tube and the wall of the trachea, can travel deep into a child's lungs with devastating outcomes.

Brian P. Helmke, an associate professor of biomedical engineering at the University of Virginia, hopes to reduce the incidence of such illnesses by using fluid propulsion technology to engineer the surface of the tube so that it mimics the natural surface of the trachea. Helmke received a Hartwell Individual Biomedical Research Award for his project, "Ciliated Pediatric Endotracheal Tube for Active Prevention of Ventilator-Associated Pneumonia."

"The Hartwell Foundation seeks to fund early-stage transformative ideas like that proposed by Helmke," foundation president Fred Dombrose said. "With a cutting-edge concept that addresses an important and unmet clinical need, his potential for success comes with high risk, but with a potential for substantial impact in pediatric health care."

"If we can keep fluid from pooling around the endotracheal tube by creating a fluid propulsion system, the incidence of ventilator-associated pneumonia will decrease," Helmke said. "Typically the fluid is drained by suction, but this procedure is manually intensive and risks damaging the airway and its natural cilia by drying out the protective mucus."

Cilia are tail-like projections which extend from cells. In the trachea, or windpipe, the cilia line the surface of the trachea and sweep dirt and mucus from the airways. Cilia move in coordinated waves, propelling whatever they touch along the airway surface.

Helmke will use his Hartwell grant to develop artificial cilia on the outside of the endotracheal tube to act in place of the natural cilia. He plans to design micro-fabricated polymer structures, shaped as pillars or "fingers," with different configurations and materials to mimic the natural cilia's ability to move in coordinated waves.

Helmke qualified to apply for the grant because the Hartwell Foundation has again selected U.Va. as one of its "Top Ten Centers of Biomedical Research," offering the University the opportunity to nominate four candidates for consideration as Hartwell Investigators. Helmke will receive $100,000 a year for three years. He is one of 12 Hartwell recipients nationally this year.

"U.Va. is especially proud to be a part of the Hartwell Foundation's vision," said Thomas Skalak, U.Va. vice president for research. "We share the foundation's belief that risk-taking and innovation by creative individuals at the frontiers of established fields is essential to break new ground and achieve great leaps forward. This type of research is essential to help children in need."

Based in Memphis, Tenn., the primary mission of the Hartwell Foundation is to grant awards to individuals for innovative and cutting-edge biomedical applied research that could potentially benefit children. The general aim is to provide funds for early-stage research projects that have not yet qualified for funding from traditional sources.

"We are extremely grateful for the Hartwell Foundation's continued recognition of our biomedical engineering program and their generous support of our research approaches in children's health," said Steven DeKosky, vice president and dean of the U.Va. School of Medicine. "Ventilator-associated pneumonia is a case where we may do more harm while trying to heal. Helmke's work could lead to the breakthrough needed to avoid this medical complication and save thousands of lives each year."

More information about the Hartwell Foundation is available on its Web site at www.thehartwellfoundation.

More information about the U.Va. School of Medicine is available at www.healthsystem.virginia.edu/internet/som/home.cfm.