a 2015 systematic review concluded that the limited evidence available indicates that using silver‐coated endotracheal breathing tubes reduces the risk of contracting ventilator-associated pneumonia (vap), especially during the initial days of utilisation. a 2014 study concluded that using silver-coated endotracheal tubes will help to prevent vap and that this may save on hospital costs. a 2012 systematic review of randomized controlled trials concluded that the limited evidence available indicates that using silver‐coated endotracheal tubes will reduce the incidence of ventilator-associated pneumonia, microbiologic burden, and device‐related adverse events among adult patients. another 2012 review agreed that the use of silver-coated endotracheal tubes reduces the prevalence of vap in intubated patients, but cautioned that this on its own is not sufficient to prevent infection. they also suggested that more research is needed to establish the cost-effectiveness of the treatment. another 2012 study agreed that there is evidence that endotracheal tubes coated with silver may reduce the incidence of ventilator associated pneumonia (vap) and delay its onset, but concluded that no benefit was seen in the duration of intubation, the duration of stay in intensive care or the mortality rate. they also raised concerns surrounding the unblinded nature of some of the studies then available.