Effect of subglottic secretion drainage on the prevention of ventilator associated pneumonia

Abstract

Objective To assess the influence of subglottic secretion drainage(SSD)on the prevention of ventilator associated pneumonia(VAP).Methods 63 patients in the intensive care unit(ICU)who received mechanical ventilation above 48 hours were divided into two groups named group A(31 cases)and group B(32 cases).Group A received SSD 1 time per 6 hours while group B only got SSD at 48 hours,the 4th,7th and 14th days when samples were got.We brushed away secretion from airway and also monitored bacteriology of the subglottic secretion between the two groups. Results The incidence rate of VAP in group A was 6.1%and was evidently lower than that of group B(P 0.05).The onset time of VAP was later anti the bacteria number in the subglottic secretion was less in group A than those in group B(P<0.01).The same bacteria strain was found in the subglottic secretion and airway secretions in 13 patients out of 22 VAP patients.The dominant bacteria were P.aeruginosa,K.pneumonia,Staphylococcus aureus and Pseudomonas stenotrophomonas. Conclusion SSD could reduce the bacteria concentration in subglottic secretion,decrease VAP incidence and delay the onset of VAP.Migration of dominant bacteria from the subglottic secretion was one of the important causes of VAP. Key words: Ventilator associated pneumonia; Subglottic secretion drainage; Intensive care unit