Abstract
BACKGROUND: development of ventilator associated pneumonia (VAP) leads to ‎prolonged hospital stay, increased health care cost, and mortality rates. Subglottic ‎secretion drainage through a dedicated endotracheal tube has been advocated as a mean ‎to decrease the incidence of VAP and thereby assisting in ‎the decrease of morbidity associated with invasive mechanical ventilation.‎
 
 OBJECTIVE: Investigate the role of subglottic secretion suctioning in the prevention of VAP in mechanically ventilated patients in intensive care unit.‎
 
 METHODS: A cross sectional study done in the intensive care unit of Ghazi Al-Hariri ‎hospital for surgical specialties in medical city complex, 30 patients who ‎are in need for invasive mechanical ventilation were intubated with endotracheal tube ‎that have special port for subglottic secretion suctioning. Daily monitoring of patients ‎clinical and radiological data to detect features of VAP was ‎done, and if there was a suspicion of pneumonia, culture for tracheal aspirate performed ‎to confirm diagnosis.‎
 
 RESULTS: ‎Patient’s age was 37.1 ± ‎‎15.39 years, the highest proportion of study patients was found in ‎age group < 30 and ‎‎30–49 years (40% in ‎each group), most of the patients were males (70%) with a male to female ratio of ‎‎2.33:1‎‏, ‏Subglottic secretion suctioning lead to reduction in VAP by relative risk (95%CI) of ‏‎0.167 (0.045–0.559)‎‏, p-‏value = 0.001. ‏Twenty eight patients didn’t show any sign, symptoms ‎or radiological features suggesting a ‎diagnosis of pneumonia while two patients developed ‎features of pneumonia (suggestive signs and ‎symptoms, radiological features and ‎positive culture of tracheal aspirate).‎
 
 CONCLUSION: the use of endotracheal tube with subglottic ‎secretions suctioning can have a role in the prevention of VAP in mechanically ventilated patients.‎
Highlights
Ventilator-associated pneumonia (VAP) is one of the most frequent hospital-acquired infections encountered in critically ill patients receiving mechanical ventilation
A cross sectional study done in the intensive care unit of Ghazi Al-Hariri hospital for surgical specialties in medical city complex, 30 patients who are in need for invasive mechanical ventilation were intubated with endotracheal tube that have special port for subglottic secretion suctioning
Patient’s age was 37.1 ± 15.39 years, the highest proportion of study patients was found in age group < 30 and 30–49 years (40% in each group), most of the patients were males (70%) with a male to female ratio of 2.33:1,Subglottic secretion suctioning lead to reduction in VAP by relative risk (95%CI) of 0.167 (0.045–0.559), p-value = 0.001
Summary
Ventilator-associated pneumonia (VAP) is one of the most frequent hospital-acquired infections encountered in critically ill patients receiving mechanical ventilation. VAP is defined as pneumonia that develops 48 hours after patient been placed on mechanical ventilation. It is an important subset of hospital-acquired pneumonia (HAP), which occurs 48hours or longer after admission to the hospital and results from an infection that was not incubating at the time of admission (Kalanuria, Ziai, & Mirski, 2014). It is estimated that the risk of development of VAP is about 3% per day during the 5 days of receiving mechanical ventilation, 2% per day for days 5 through and 1% thereafter.
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