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2018, Number 1

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Med Crit 2018; 32 (1)

Subglottic secretion drainage tracheal tube and risk of ventilator-associated pneumonia

Fernández GER, Corona MJC

Language: Spanish
References: 30
Page: 34-40
PDF size: 210.67 Kb.


ABSTRACT

Background: Traqueal tube is the main risk factor for ventilator-associated pneumonia (VAP).
Objective: Efficacy documentation of VAP reduction with endotracheal tube with subglottic secretion suction (ETSS).
Methods: A case-control study from May 2012 to December 2015 in an intensive care unit. Patients who met the definition for VAP were considered as cases, and the exposition factor was the use of ETSS. Using a convenience sample with case:control rate of 1:3, α = 95% and β = 80%, a total of 18 cases and 54 controls were required. BMI® SPSS® Statistics v21 was used for the statistical analysis.
Results: A total of 1,492 patients received attention in the ICU during the study period, with 277 (18.5%) requiring mechanical ventilation (2,040 ventilator-days). We included 23 cases in the VAP group and 67 controls. The rate of VAP was 12.3/1000 ventilator-days. Eleven patients (18.3%) with ETSS and twelve (40%) without it developed VAP (OR 0.33, IC 95% 0.12-0.89; NNT = 4.6). A significant correlation was found between VAP and bundle care adherence (r = 0.223, p = 0.036), days on mechanical ventilation (r = -0.51, p ‹ 0.0001), and length of stay in the ICU (r = 0.42, p ‹ 0.0001).
Conclusions: ETSS use and care bundles adherence significantly reduced VAP risk in the intensive care unit, and shortened the days on mechanical ventilation and the length of stay.


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