Single-Use Versus Multiple-Use Endotracheal Suction Catheters in Mechanically Ventilated Patients: A Feasibility...

Area of Science:

• Critical Care Medicine
• Infectious Disease Prevention
• Health Systems Research

Background:

• Single-use endotracheal suction catheters are often reused in resource-limited settings, with unclear effects on ventilator-associated pneumonia (VAP).
• Evidence regarding the impact of reusing open endotracheal suction catheters on VAP in mechanically ventilated patients is limited.

Purpose of the Study:

• To assess the feasibility of single-use and chlorhexidine-flushed multiple-use endotracheal suction catheters for VAP reduction in resource-limited intensive care units (ICUs).
• To evaluate study methodologies for a future definitive randomized controlled trial (RCT).

Main Methods:

• A three-armed feasibility RCT involving 60 mechanically ventilated patients in three Egyptian ICUs.
• Patients were randomized to: Intervention I (single-use catheters), Intervention II (chlorhexidine-flushed multiple-use catheters), or Control (standard care with normal saline).
• Feasibility, adherence, and patient outcomes including VAP incidence were assessed over 6 days.

Main Results:

• High recruitment (96.7%) and retention (93.3%) rates were achieved, with 100% adherence to interventions.
• No adverse events were reported; chlorhexidine flushing and single-use catheters proved practical.
• VAP incidence was 31.6% (Intervention I), 26.3% (Intervention II), and 40% (Control). Relative risk for VAP was 0.79 for Intervention I and 0.66 for Intervention II compared to control.

Conclusions:

• A full-scale RCT on single-use and chlorhexidine-flushed catheters for VAP prevention in resource-limited ICUs is feasible.
• These strategies show potential for reducing VAP and can inform clinical practice and infection control in resource-limited settings.