Abstract
The aim of the study was to investigate whether polyurethane (PU) endotracheal tubes, continuous measurements of cuff pressure and aspiration of the subglottic space as a bundle of parameters could reduce patients' risk for developing ventilator associated pneumonia (VAP). Two groups of patients that differed only in terms of endotracheal tubes and intubation intervention were compared. GroupA was ventilated using PU tubes a with conical cuff; they also had continuous cuff pressure measurement and continuous subglottic aspiration. GroupB was ventilated using PVC tubes with a cylindrical cuff; the patients underwent intermittent cuff pressure measurement and intermittent subglottic aspiration. Seven patients in groupA (13.2%) and 18 in groupB (36.0%) out of 103 were diagnosed with VAP. VAP patients were in general older, stayed longer in the ICU and were ventilated significantly longer compared with the patients with no VAP. Eight more patients in groupB died compared with groupA. Moreover, subjects in groupA survived longer. Patient age, hours on mechanical ventilation, and days on an ICU were all positively associated with the occurrence of VAP. Prevention parameters in ventilation (PU cuff, conical cuff, continuous subglottic drainage and continuous cuff pressure measurement) could prevent the incidence of VAP in ICU patients.
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