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Indian Journal of Critical Care Medicine
Medknow Publications on behalf of the Indian Society of Critical Care Medicine
ISSN: 0972-5229
EISSN: 1998-359x
Vol. 15, No. 3, 2011, pp. 168-172
Bioline Code: cm11042
Full paper language: English
Document type: Research Article
Document available free of charge

Indian Journal of Critical Care Medicine, Vol. 15, No. 3, 2011, pp. 168-172

 en Comparing influence of intermittent subglottic secretions drainage with/without closed suction systems on the incidence of ventilator associated pneumonia
Juneja, Deven; Javeri, Yash; Singh, Omender; Nasa, Prashant; Pandey, Rameshwar & Uniyal, Bhupesh

Abstract

Context: Intermittent subglottic drainage (ISD) of secretions is recommended for prevention of ventilator-associated pneumonia (VAP) as it reduces microaspiration from the area around the cuff. Poor suction techniques can contribute to VAP, hence closed suction system (CSS) may have theoretical benefit in VAP prevention. Combination of these two techniques may provide added advantage.
Aims: To study the influence of ISD with/without CSS on the incidence of VAP.
Materials and Methods: Data from 311 patients requiring mechanical ventilation (MV) for more than 72 hours were collected retrospectively. They were divided into four groups as follows: group A, no intervention; group B, only CSS; group C, only ISD; and group D, ISD with CSS. These groups were compared with respect to incidence of VAP, duration of MV, length of ICU and hospital stay and ICU mortality.
Results: Patients in the four groups were comparable with respect to age, sex ratio and admission Acute Physiology and Chronic Health Evaluation (APACHE) II scores. Incidence of VAP per 1000 ventilator days in groups A, B, C, and D were 25, 23.9, 15.7 and 14.3, respectively (P=0.04). There was no significant difference in the duration of MV (P=0.33), length of ICU (P=0.55) and hospital stay (P=0.36) and ICU mortality (P=0.9) among the four groups.
Conclusions: ISD of secretions reduces the incidence of VAP. CSS alone or in combination with ISD has no significant effect on VAP incidence. Hence, ISD may be recommended for VAP prevention, but indications other than VAP prevention should determine the type of the suction system.

Keywords
Closed suction system, intermittent subglottic drainage, ventilator-associated pneumonia

 
© Copyright 2011 Indian Journal of Critical Care Medicine.
Alternative site location: http://www.ijccm.org/

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