Subglottic secretion drainage and continuous control of cuff pressure used together save health care costs

Abstract

Preventive strategies to reduce ventilator-associated respiratory infection (VARI) include the use of an endotracheal tube incorporating a lumen for subglottic secretion drainage (SSD) and a system for continuous control of endotracheal tube cuff pressure (CCCP). The health care costs associated with the combined use of these 2 measures aimed at preventing VARI are not known, however. The objective of this study was to determine whether the simultaneous use of these 2 preventive measures for VARI could save health care costs. We performed a prospective observational study of patients who needed mechanical ventilation in an intensive care unit. The health care costs considered here included only the costs of the endotracheal tube, cuff control, and antimicrobials used to treat VARI. The study cohort comprised 656 patients, including 241 with intermittent control of cuff pressure and without SSD (standard group), 260 with CCCP and without SSD (CCCP group), 84 with intermittent control of cuff pressure and with SSD (SSD group), and 71 with CCCP and SSD (CCCP + SSD group). The incidence of VARI and health care costs were lower in the CCCP + SSD group compared with the standard, CCCP, and SSD groups. The combined use of SSD and CCCP reduced the incidence of VARI and saved health care costs.