Marta Walaszek1,2, Agnieszka Gniadek3, Malgorzata Kolpa2, Zdzislaw Wolak2, Alicja Kosiarska2. 1. Sw. Lukasz Provincial Hospital in Tarnow, Poland. 2. Department of Nursing, Institute of Health Sciences, State Higher Vocational School in Tarnow, Poland. 3. Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland.
Abstract
BACKGROUND: Ventilator-Associated Pneumonia (VAP) is an undesired side effect of mechanical ventilation in intensive care units (ICUs). AIM: We evaluated whether endotracheal tubes with subglottic secretion drainage (SSD) would reduce the incidence of VAP among patients undergoing mechanical ventilation in an ICU. METHODS: The analysis of medical records of patients undergoing mechanical ventilation exceeding 48 h who were hospitalised in ICUs between 2007 and 2014 led to separating two groups of patients: those in whom no subglottic drainage was applied (NSSD) (records dating from 2007-2010) and those whose treatment involved endotracheal tubes with subglottic secretion drainage (SSD) (records dating from 2011-2014). RESULTS: Analysis of 1807 patients hospitalised in ICUs (804 NSSD patients and 1003 SSD patients). A difference was found in the frequency of VAP incidence between the groups (P<0.001). In the NSSD group as many as 84 cases were reported (incidence: 10.7%), and in the SSD group - 43 cases (incidence: 5.2%). The odds ratio (OR) and relative risk (RR) was 2.5. The probability of VAP was significantly higher in the NSSD group. The risk factors of VAP incidence (P<0.001) included the correlation between reintubation (R=0.271), tracheostomy (R=0.309) and bronchoscopy (R=0.316). CONCLUSION: Use of endotracheal tubes with subglottic secretion drainage in patients in the ICU on mechanical ventilation significantly reduced the incidence of VAP.
BACKGROUND: Ventilator-Associated Pneumonia (VAP) is an undesired side effect of mechanical ventilation in intensive care units (ICUs). AIM: We evaluated whether endotracheal tubes with subglottic secretion drainage (SSD) would reduce the incidence of VAP among patients undergoing mechanical ventilation in an ICU. METHODS: The analysis of medical records of patients undergoing mechanical ventilation exceeding 48 h who were hospitalised in ICUs between 2007 and 2014 led to separating two groups of patients: those in whom no subglottic drainage was applied (NSSD) (records dating from 2007-2010) and those whose treatment involved endotracheal tubes with subglottic secretion drainage (SSD) (records dating from 2011-2014). RESULTS: Analysis of 1807 patients hospitalised in ICUs (804 NSSD patients and 1003 SSDpatients). A difference was found in the frequency of VAP incidence between the groups (P<0.001). In the NSSD group as many as 84 cases were reported (incidence: 10.7%), and in the SSD group - 43 cases (incidence: 5.2%). The odds ratio (OR) and relative risk (RR) was 2.5. The probability of VAP was significantly higher in the NSSD group. The risk factors of VAP incidence (P<0.001) included the correlation between reintubation (R=0.271), tracheostomy (R=0.309) and bronchoscopy (R=0.316). CONCLUSION: Use of endotracheal tubes with subglottic secretion drainage in patients in the ICU on mechanical ventilation significantly reduced the incidence of VAP.