Biomedical papers - Ahead of Print

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | 10.5507/bp.2017.041

The effect of subglottic secretion drainage on the incidence of ventilator associated pneumonia

Marta Walaszeka,c, Agnieszka Gniadekb, Malgorzata Kolpac, Zdzislaw Wolakc, Alicja Kosiarskac
a Sw. Lukasz Provincial Hospital in Tarnow, Poland
b Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
c Department of Nursing, Institute of Health Sciences, State Higher Vocational School in Tarnow, Poland

Background: Ventilator-Associated Pneumonia (VAP) is an undesired side effect of mechanical ventilation in intensive care units (ICUs).

Aim: We evaluated whether endotracheal tubes with subglottic secretion drainage (SSD) would reduce the incidence of VAP among patients undergoing mechanical ventilation in an ICU.

Methods: The analysis of medical records of patients undergoing mechanical ventilation exceeding 48 h who were hospitalised in ICUs between 2007 and 2014 led to separating two groups of patients: those in whom no subglottic drainage was applied (NSSD) (records dating from 2007-2010) and those whose treatment involved endotracheal tubes with subglottic secretion drainage (SSD) (records dating from 2011-2014).

Results: Analysis of 1807 patients hospitalised in ICUs (804 NSSD patients and 1003 SSD patients). A difference was found in the frequency of VAP incidence between the groups (P<0.001). In the NSSD group as many as 84 cases were reported (incidence: 10.7%), and in the SSD group - 43 cases (incidence: 5.2%). The odds ratio (OR) and relative risk (RR) was 2.5. The probability of VAP was significantly higher in the NSSD group. The risk factors of VAP incidence (P<0.001) included the correlation between reintubation (R=0.271), tracheostomy (R=0.309) and bronchoscopy (R=0.316).

Conclusion: Use of endotracheal tubes with subglottic secretion drainage in patients in the ICU on mechanical ventilation significantly reduced the incidence of VAP.

Keywords: ventilator-associated pneumonia (VAP), subglottic secretion drainage (SSD), endotracheal tube (ETT)

Received: May 7, 2017; Accepted: September 12, 2017; Prepublished online: October 17, 2017


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