Clinical Study On Subglottic Secretion Drainage On Prevention Of Ventilator-associated Pneumonia In Patients Receiving Mechanical Ventilation

Objective: To study the preventive function of intermittent subglottic secretions drainage (ISSD) on the ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation.Methods: With a prospective, randomized, case-control design, patients with duration of mechanical ventilation > 48h were enrolled in the study. Patients were randomly assigned to receive either a special type endotracheal tube for ISSD or usual care (NON-ISSD) respectively. The number of cases with VAP were recorded. Outcome of bacterial culture of samples from subglottic secretions, low respiratory tract, oropharynx and gastric fluid and semiquantitative outcome of them were recorded.Results: Fifty-eight patients were enrolled. Twenty-eight patients were randomized to ISSD, and thirty patients were randomized to the control group. The morbidity of VAP in the ISSD group(7.1%) was lower than that in the control group (33.3%), P<0.05.There was significant difference between two groups. Bacterial contents of subglottic secretion of ISSD group was lower than NON-ISSD group, P<0.05. There was significant difference between two groups.Conclusion: There is significant difference in bacterial contents of subglottic secretion and morbidity of VAP between two groups. ISSD reduces morbidity of VAP and bacterial contents of subglottic secretion.