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The effect of subglottic secretion drainage on the incidence of ventilator associated pneumonia
Marta Walaszek1,2, Agnieszka Gniadek3, Malgorzata Kolpa2
1Sw. Lukasz Provincial Hospital 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.
Insights
Subglottic secretion drainage (SSD) endotracheal tubes significantly reduced ventilator-associated pneumonia (VAP) incidence in ICU patients. This intervention lowered VAP rates from 10.7% to 5.2%, highlighting its effectiveness in critical care settings.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Respiratory Medicine
Background:
- Ventilator-associated pneumonia (VAP) is a common complication in intensive care units (ICUs).
- Mechanical ventilation, while life-saving, increases the risk of VAP.
- Effective preventative strategies for VAP are crucial in critical care.
Purpose of the Study:
- To evaluate the efficacy of endotracheal tubes with subglottic secretion drainage (SSD) in reducing VAP incidence.
- To compare VAP rates in patients with and without SSD endotracheal tubes.
- To identify risk factors associated with VAP in mechanically ventilated patients.
Main Methods:
- Retrospective analysis of 1807 ICU patients undergoing mechanical ventilation for over 48 hours (2007-2014).
- Two groups were compared: those without subglottic drainage (NSSD, 2007-2010) and those with SSD endotracheal tubes (SSD, 2011-2014).
- Incidence of VAP, odds ratio (OR), and relative risk (RR) were calculated.
Main Results:
- VAP incidence was significantly lower in the SSD group (5.2%) compared to the NSSD group (10.7%) (P<0.001).
- The odds ratio for VAP was 2.5, indicating a higher probability in the NSSD group.
- Reintubation, tracheostomy, and bronchoscopy were identified as significant risk factors for VAP.
Conclusions:
- Endotracheal tubes with subglottic secretion drainage are effective in reducing VAP incidence in mechanically ventilated ICU patients.
- The use of SSD technology represents a significant advancement in VAP prevention.
- Further research into VAP risk factors can optimize patient care protocols.