Abstract
Introduction: Subglottic secretion drainage reduces the incidence of ventilator associated pneumonia (VAP). The efficacy of Continuous subglottic secretion drainage (CSSD) over Intermittent subglottic secretion drainage (ISSD) for prevention of VAP is unknown.
 Objectives: Compare the efficacy of CSSD and ISSD in terms of incidence of VAP, mortality, duration of mechanical ventilation, length of ICU stay and incidence of reintubation.
 Methodology: This was a prospective comparative study conducted at Birat Medical College and Teaching Hospital. A total number of 80 intubated patients for at least 48 hours duration were included. Continuous and intermittent endotracheal suctioning techniques were compared for prevention of VAP and secondary outcomes in terms of length of mechanical ventilation, length of ICU stay, multiorgan failure, reintubation and mortality rate.
 Results: The incidence of VAP was 15% and 22.5 % in CSSD group while it was 17.5% and 27.5% in ISSD group in first 48 hours and 96 hours of mechanical ventilation respectively.The length of mechanical ventilation was significantly less in continuous group (4.78 ± 2.50 days) than in intermittent group (7.18 ± 2.09 days) with p value of 0.023. The patients with CSSD had significantly shorter ICU stay (5.49 ± 3.16 days) as compared to the patients with ISSD (8.46 ± 2.06 days). The incidence of reintubation was significantly higher in intermittent group patients (p value 0.024). Patients in both the group had comparable incidence of multiorgan failure, spontaneous breathing trial and mortality rate.
 Conclusion: The incidences of VAP and mortality were comparable in CSSD and ISSD. However CSSD significantly decreased the duration of mechanical ventilation, length of ICU stay and incidence of reintubation..
Highlights
Ven lator associated pneumonia is one of the common consequences of mechanical ven la on in cri cally ill pa ents in intensive care unit
The incidences of ven lator associated pneumonia (VAP) and mortality were comparable in CSSD and Intermi ent subglo c secre on drainage (ISSD)
Compara ve Study Of Con nuous Versus Intermi ent Subglo c Suc on Drainage To Prevent Ven lator Associated Pneumonia In Intubated Pa ents
Summary
Ven lator associated pneumonia is one of the common consequences of mechanical ven la on in cri cally ill pa ents in intensive care unit. It is a nosocomial infec on which occurs a er 48 hours of endotracheal intuba on. It can occur as early as first 96 hours of mechanical ven la on. VAP which occurs more than 96 hours a er mechanical ven la on is more common due to mul drug resistant microorganisms.[1]. The overall rate of VAP is 13.6 per 1000 ven lator days according to Interna onal Nosocomial Infec on Control Consor um.[2]. The incidence of VAP ranges between 9 - 27% in ICU despite wide use of preven ve measures and the crude mortality rate ranges from 25%-50%.3, 4-6 VAP increases health care costs by increasing stay in ICU.[2,7,8]
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