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Impact of subglottic secretion drainage on microaspiration in critically ill patients: a prospective observational

Guillaume Millot1, Pauline Boddaert1, Erika Parmentier-Decrucq1

  • 1CHU Lille, Critical Care Center, Lille, France.

Annals of Translational Medicine
|December 25, 2018
PubMed
Abstract

Insights

Subglottic secretion drainage (SSD) did not reduce microaspiration or ventilator-associated pneumonia (VAP) in this study. The incidence of microaspiration, VAP, and airway colonization remained similar between groups.

Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Infectious Diseases

Background:

  • Microaspiration is a key factor in ventilator-associated pneumonia (VAP) development.
  • Subglottic secretion drainage (SSD) is a technique designed to decrease VAP incidence.

Purpose of the Study:

  • To evaluate the effectiveness of SSD in reducing gastric or oropharyngeal microaspiration.
  • To assess the impact of SSD on VAP, ventilator-associated tracheobronchitis (VAT), and airway colonization.

Main Methods:

  • A single-center prospective observational study was conducted in an ICU.
  • Adult patients on mechanical ventilation were divided into SSD and control groups.
  • Tracheal aspirates were analyzed for pepsin and salivary amylase concentrations over 24 hours.

Main Results:

  • No significant difference in microaspiration incidence was observed between the SSD and control groups (89% vs. 82%, P=0.469).
  • The study found no significant differences in VAP (29% vs. 24%), VAT (13% vs. 9%), or airway colonization (35% vs. 18%) rates between the groups.
  • Fifty-five patients were in the SSD group and 45 in the control group.

Conclusions:

  • Subglottic secretion drainage (SSD) did not effectively reduce the incidence of microaspiration in this study.
  • SSD did not demonstrate a significant impact on reducing VAP, VAT, or airway colonization.
Keywords:
Ventilator-associated pneumonia (VAP)microaspirationsubglottic secretion drainage (SSD)

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