scholarly journals A comparative study on prevention of ventilator associated pneumonia using endotracheal tube with or without intermittent subglottic secretion drainage device

2018 ◽  
Vol 6 (1) ◽  
pp. 7-15
Author(s):  
Mohammad Asaduzzaman ◽  
Mohammad Omar Faruq ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Primary Outcome ◽  
Late Onset ◽  
Clinical Suspicion ◽  
Ventilator Associated Pneumonia ◽  
Quantitative Culture ◽  
Subglottic Secretion ◽  
Drainage Device ◽  
Subglottic Secretion Drainage ◽  
Substantial Morbidity

Context: Ventilator-associated pneumonia (VAP) causes substantial morbidity and mortality. The influence of intermittent subglottic secretion drainage (SSD) in preventing VAP has been supported by literature studies.Objective: To find out the effectiveness of subglottic secretion drainage (SSD) on prevention of ventilator associated pneumonia (VAP) using endotracheal tube with subglottic secretion drainage (ETT-SSD).Methodology: This study was carried out in the 10 beded medical-care Intensive Care Unit (ICU) of BIRDEM Hospital, Dhaka over a period of one and half year, enrolling 48 subjects. Patients expected to require mechanical ventilation (MV) for more than >48 hrs were randomly assigned to one of two groups: one was ventilated with ETT-SSD and the other with conventional endotracheal tube (ETT-C).Results: Primary outcome was the overall incidence of VAP based on quantitative culture of distal pulmonary samplings performed after each clinical suspicion. Other outcomes included incidence of early and late onset VAP, duration of MV, duration of ICU stay and in hospital mortality. Microbiologically confirmed VAP occurred in 23 patients, 6 of 24 (25%) in the SSD group and 17 of 24 (70.83%) in the control group.Conclusion: The use of an ETT with intermittent SSD in a patient on MV helps to prevent ventilator associated pneumonia.Bangladesh Crit Care J March 2018; 6(1): 7-15

scholarly journals Ventilator Associated Pneumonia in Patients Using Endotracheal Tube with Intermittent Subglottic Secretion Drainage and Using Endotracheal Tube without Drainage

2021 ◽  
Vol 9 (4) ◽  
pp. 506-511
Author(s):  
  Md. Zubyeer Ali Sheikh ◽  
A. K. Qumrul Huda ◽  
Montosh Kumar Mondal ◽  
Md. Mohiuddin Majed Chy ◽  
Mohammad Mahbubuzzaman ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Ventilator Associated Pneumonia ◽  
Subglottic Secretion ◽  
Subglottic Secretion Drainage

scholarly journals Efficacy of Hi-Lo Evac Endotracheal Tube in Prevention of Ventilator-Associated Pneumonia in Mechanically Ventilated Poisoned Patients

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Ahmad Ghoochani Khorasani ◽  
Shahin Shadnia ◽  
Mohammad Mashayekhian ◽  
Mitra Rahimi ◽  
Abbas Aghabiklooei
Keyword(s):  
Endotracheal Tube ◽  
Control Group ◽  
Case Group ◽  
Ventilator Associated Pneumonia ◽  
Mechanically Ventilated ◽  
Subglottic Secretion ◽  
Icu Length Of Stay ◽  
Significant Difference ◽  
Subglottic Secretion Drainage ◽  
Health Care Associated Infection

Background. Ventilator-associated pneumonia (VAP) is the most common health care-associated infection. To prevent this complication, aspiration of subglottic secretions using Hi-Lo Evac endotracheal tube (Evac ETT) is a recommended intervention. However, there are some reports on Evac ETT dysfunction. We aimed to compare the incidence of VAP (per ventilated patients) in severely ill poisoned patients who were intubated using Evac ETT versus conventional endotracheal tubes (C-ETT) in our toxicology ICU.Materials and Methods. In this clinical randomized trial, 91 eligible patients with an expected duration of mechanical ventilation of more than 48 hours were recruited and randomly assigned into two groups: (1) subglottic secretion drainage (SSD) group who were intubated by Evac ETT (n=43) and (2) control group who were intubated by C-ETT (n=48).Results. Of the 91 eligible patients, 56 (61.5%) were male. VAP was detected in 24 of 43 (55.8%) patients in the case group and 23 of 48 (47.9%) patients in the control group (P=0.45). The most frequently isolated microorganisms wereS. aureus(54.10%) andAcinetobacterspp. (19.68%). The incidence of VAP and ICU length of stay were not significantly different between the two groups, but duration of intubation was statistically different and was longer in the SSD group. Mortality rate was less in SSD group but without a significant difference (P=0.68).Conclusion. The SSD procedure was performed intermittently with one-hour intervals using 10 mL syringe. Subglottic secretion drainage does not significantly reduce the incidence of VAP in patients receiving MV. This strategy appears to be ineffective in preventing VAP among ICU patients.

Subglottic Secretion Drainage

2007 ◽  
Vol 18 (4) ◽  
pp. 366-379 ◽  
Author(s):  
Charlotte L. DePew ◽  
Mary S. McCarthy
Keyword(s):  
Endotracheal Tube ◽  
American Association ◽  
American Thoracic Society ◽  
Critical Care Nurses ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Subglottic Secretion ◽  
Control And Prevention ◽  
Subglottic Secretion Drainage ◽  
Research Recommendations

Ventilator-associated pneumonia is a costly complication of hospitalization that lengthens intensive care unit and hospital stay, increasing morbidity and mortality. Among evidence-based measures to prevent ventilator-associated pneumonia is the use of a specialized endotracheal tube that aspirates subglottic secretions. Recommendations for subglottic aspiration are found in guidelines by the Centers for Disease Control and Prevention, American Association of Critical-Care Nurses, and the American Thoracic Society. The purpose of this article is to review the available evidence regarding the use of an endotracheal tube with a subglottic secretion aspiration port to prevent ventilator-associated pneumonia. Issues, cost, benefits, and research recommendations will also be discussed.

scholarly journals Study of quantitative bacterial cultures of non-bronchoscopic samples in ventilator associated pneumonia

2018 ◽  
Vol 5 (5) ◽  
pp. 1837 ◽  
Author(s):  
Mohamed Azarudeen ◽  
B. S. Sharma ◽  
Pankaj Kumar Jain ◽  
Alok Kumar Goyal ◽  
Bharti Malhotra
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Early Onset ◽  
Late Onset ◽  
Sampling Techniques ◽  
Ventilator Associated Pneumonia ◽  
Quantitative Culture ◽  
Gram Negative ◽  
Bacterial Cultures ◽  
Causative Agents

Background: Diagnosis of VAP based on non bronchoscopic samples-ETA, NB-BAL culture. The aim is to study quantitative culture of the non-bronchoscopic sampling techniques such as Blind Broncho-alveolar lavage (NB-BAL) and endotracheal aspirates (ETA)in Ventilator Associated Pneumonia. It is a hospital based, observational study conducted in SPMCHI, Jaipur from September 2015 to September 2016.Methods: Seventy patients who were under mechanical ventilation for more than 48 hours and clinically suspected for VAP were included in the study and divided into early and late onset VAP. The NB-BAL and ETA were obtained from these patients and quantitative cultures were performed.Results: Out of the 70 samples analysed, 60 patients were found positive in BAL and 61 positive in ETA. The agreement between NB-BAL and ETA is 86.8%. GNBs remain the main burden of both early and late onset VAP. Most common organisms isolated were Enterobacter and Acinetobacter in early onset and Pseudomonas and Acinetobacter in late onset VAP. All the GNB isolates were sensitive to Polymyxin and Colistin and were resistant to majority of routinely used antibiotics.Conclusions: The quantitative culture of   non-bronchoscopic samples is a useful alternative to bronchoscopy, in the diagnosis of VAP in resource deprived centers. MDR gram negative bacilli are the main causative agents of VAP. 

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