Effect of two methods of subglottic secretion drainage on the incidence of ventilator-associated pneumonia

Abstract

To observe the effect of two different ways of subglottic secretion drainage on the incidence of ventilator-associated pneumonia. A total of 149 patients receiving mechanical ventilation from October 2007 to February 2010 in our hospital were enrolled in our study. According to the random number table, they were divided into 3 groups: a control group (47), a intermittent drainage group (54), and a continuous drainage group (48). There was no significant difference in APACHE II score before intubation in the patients of the 3 groups. Conventional treatment and care was performed in the control group, while subglottic rinse was performed every 4 h in the intermittent drainage group and continuous aspiration in the continuous drainage group. The incidence and mortality of ventilator-associated pneumonia were compared among groups within 30 days after intubation. The tolerance and complications were observed. The incidence rate of early onset ventilator-associated pneumonia in the intermittent drainage group (13.0%) and the continuous drainage group (14.6%) was significantly lower than that in the control group (40.4%), and the difference was statistically significant (χ(2) = 9.914, 7.978;P = 0.002,0.005), but there was no difference between the former 2 groups (χ(2) = 0.056; P = 0.812). There was no significant difference in the incidence of late-onset ventilator-associated pneumonia or mortality among groups (P > 0.05). Good tolerance of the 2 methods was observed. Subglottic secretion drainage by both the intermittent and the continuous methods can efficiently prevent early onset ventilator-associated pneumonia.