Ata Mahmoodpoor1, Hadi Hamishehkar2, Masoud Hamidi3, Kamran Shadvar4, Sarvin Sanaie5, Samad Ej Golzari6, Zahid Hussain Khan7, Nader D Nader8. 1. Department of Anesthesiology and Critical Care Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: amahmoodpoor@yahoo.com. 2. Department of Clinical Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: hamishehkar@gmail.com. 3. Department of Anesthesiology and Critical Care Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: masoodhamidi59@yahoo.com. 4. Department of Anesthesiology and Critical Care Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: k_shadvar@yahoo.com. 5. Tuberculosis and Lung Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: sarvin_so2000@yahoo.com. 6. Department of Anesthesiology and Critical Care Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: dr.golzari@hotmail.com. 7. Department of Anesthesiology and Critical Care Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: Khanzh51@yahoo.com. 8. Department of Anesthesiology, 252 Farber Hall, State University of New York at Buffalo, 3435 Main St, Buffalo, NY 14214. Electronic address: nnader@buffalo.edu.
Abstract
BACKGROUND:Endotracheal tube placement is necessary for the control of the airway in patients who are mechanically ventilated. However, prolonged duration of endotracheal tube placement contributes to the development of ventilator-associated pneumonias (VAPs). The aim of this study was to evaluate whether subglottic suctioning using TaperGuard EVAC tubes was effective in decreasing the frequency of VAP. METHODS: A total of 276 mechanically ventilated patients for more than 72 hours were randomly assigned to group E (EVAC tube) and group C (conventional tube). All patients received routine care including VAP prevention measures during their intensive care unit stay. In group E, subglottic suctioning was performed every 6 hours. Outcome variables included incidence VAP, intensive care unit length of stay, and mortality. RESULTS:Frequency of intraluminal suction, mechanical ventilation-free days, reintubation, the ratio of arterial oxygen partial pressure to fractional inspired oxygen and mortality rate were similar between the 2 groups (P > .05). The mean cuff pressure in group E was significantly less than that in group C (P < .001). Ventilator-associated pneumonia was significantly less in group E compared with group C (P = .015). CONCLUSION: The use of intermittent subglottic secretion suctioning was associated with a significant decrease in the incidence of the VAP in critically ill patients. However, larger multicenter trials are required to arrive at a concrete decision on routine usage of TaperGuard tubes in critical care settings. Published by Elsevier Inc.
RCT Entities:
BACKGROUND: Endotracheal tube placement is necessary for the control of the airway in patients who are mechanically ventilated. However, prolonged duration of endotracheal tube placement contributes to the development of ventilator-associated pneumonias (VAPs). The aim of this study was to evaluate whether subglottic suctioning using TaperGuard EVAC tubes was effective in decreasing the frequency of VAP. METHODS: A total of 276 mechanically ventilated patients for more than 72 hours were randomly assigned to group E (EVAC tube) and group C (conventional tube). All patients received routine care including VAP prevention measures during their intensive care unit stay. In group E, subglottic suctioning was performed every 6 hours. Outcome variables included incidence VAP, intensive care unit length of stay, and mortality. RESULTS: Frequency of intraluminal suction, mechanical ventilation-free days, reintubation, the ratio of arterial oxygen partial pressure to fractional inspired oxygen and mortality rate were similar between the 2 groups (P > .05). The mean cuff pressure in group E was significantly less than that in group C (P < .001). Ventilator-associated pneumonia was significantly less in group E compared with group C (P = .015). CONCLUSION: The use of intermittent subglottic secretion suctioning was associated with a significant decrease in the incidence of the VAP in critically illpatients. However, larger multicenter trials are required to arrive at a concrete decision on routine usage of TaperGuard tubes in critical care settings. Published by Elsevier Inc.
Entities:
Keywords:
Intensive care units; TaperGuard endotracheal tubes; Ventilator-associated pneumonia
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