Use of continuous subglottic suction in established ventilator associated pneumonia

Abstract

Background. Pneumonia is the most common nosocomial infection in intensive care units. Most of ICU­acquired pneumonias occur during mechanical ventilation; about half of them develop in the first four days after intubation. Ventilator-associated pneumonia (VAP) can be a lethal complication as it carries a mortality that may approach 50%. Methods. Continuous subglottic suction was utilized in seventeen post cardiac surgery patients with established VAP as part of the management protocol. These patients were compared with a group of 12 patients who did not have continuous subglottic suction part of their management. Results. Institution of continuous subglottic suction in patients with established ventilator associated pneumonia is of value in reducing the number of ventilator dependent days. It also decreases the likelihood of further deterioration in the pulmonary function and reduces the need for antimicrobial agents. Conclusion. Continuous subglottic suction is beneficial in case of established VAP. It prevents further soilage of the airways, speeds up convalescence and shortens the ICU stay. Ideally, it should be instituted early on in case of prolonged mechanical ventilation as one of the effective measures for the prevention of this kind of pneumonia.