Biofilms on ETT is considered as a major determinant of Ventilator Associated Pneumonia (VAP) and Ventilator Associated Tracheobronchitis (VAT) in critical care. The growth of biofilms on ETT and production of EPS should lead to detrimental ventilator associated events (VAE) and excellent computational models support this. However publications investigating the direct clinical relationship between biofilms and ventilator failure due to physical occlusion seems to be limited. We are studying these aspects in collaboration with a major tertiary care hospital in India and this question is open for collaboration and/in inputs. Thank you!