A comparative study on prevention of ventilator associated pneumonia using endotracheal tube with or without intermittent subglottic secretion drainage device

Authors

  • Mohammad Asaduzzaman Assistant Registrar, Department of Critical Care Medicine National Institute of Neurosciences and Hospital (NINSH), Sher e Bangla Nagar, Agargaw, Dhaka, 1207
  • Mohammad Omar Faruq Professor of Critical Care Medicine and Consultant of ICU, United Hospital, Gulshan 2, Dhaka
  • ASM Areef Ahsan Professor of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Kaniz Fatema Associate Professor of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Fatema Ahmed Associate Professor of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Uzzwal Kumar Mallick Registrar, Department of Critical Care Medicine, NINSH, Sher e Bangla Nagar, Agargaw, Dhaka, 1207
  • Amina Sultana Intensivist, General ICU, United Hospital, Gulshan 2, Dhaka
  • Md Motiul Islam Associate Consultant, Medical ICU, Asgar Ali Hospital., Distillary Road, Gandaria, Dhaka-1204
  • Silfat Azam Medical officer, Department of Critical Care Medicine, National Institute of Neurosciences and Hospital (NINSH), Sher e Bangla Nagar, Agargaw, Dhaka, 1207
  • Masud Kabir Medical officer, Department of Critical Care Medicine, National Institute of Neurosciences and Hospital (NINSH), Sher e Bangla Nagar, Agargaw, Dhaka, 1207
  • Jannatul Ferdous Lecturer in Bangladesh Health Professional Institute, CRP, Savar

DOI:

https://doi.org/10.3329/bccj.v6i1.36604

Keywords:

Subglottic secretion drainage (SSD), ventilator-associated pneumonia (VAP)

Abstract

Context: Ventilator-associated pneumonia (VAP) causes substantial morbidity and mortality. The influence of intermittent subglottic secretion drainage (SSD) in preventing VAP has been supported by literature studies.

Objective: To find out the effectiveness of subglottic secretion drainage (SSD) on prevention of ventilator associated pneumonia (VAP) using endotracheal tube with subglottic secretion drainage (ETT-SSD).

Methodology: This study was carried out in the 10 beded medical-care Intensive Care Unit (ICU) of BIRDEM Hospital, Dhaka over a period of one and half year, enrolling 48 subjects. Patients expected to require mechanical ventilation (MV) for more than >48 hrs were randomly assigned to one of two groups: one was ventilated with ETT-SSD and the other with conventional endotracheal tube (ETT-C).

Results: Primary outcome was the overall incidence of VAP based on quantitative culture of distal pulmonary samplings performed after each clinical suspicion. Other outcomes included incidence of early and late onset VAP, duration of MV, duration of ICU stay and in hospital mortality. Microbiologically confirmed VAP occurred in 23 patients, 6 of 24 (25%) in the SSD group and 17 of 24 (70.83%) in the control group.

Conclusion: The use of an ETT with intermittent SSD in a patient on MV helps to prevent ventilator associated pneumonia.

Bangladesh Crit Care J March 2018; 6(1): 7-15

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Published

2018-05-09

How to Cite

Asaduzzaman, M., Faruq, M. O., Ahsan, A. A., Fatema, K., Ahmed, F., Mallick, U. K., Sultana, A., Islam, M. M., Azam, S., Kabir, M., & Ferdous, J. (2018). A comparative study on prevention of ventilator associated pneumonia using endotracheal tube with or without intermittent subglottic secretion drainage device. Bangladesh Critical Care Journal, 6(1), 7–15. https://doi.org/10.3329/bccj.v6i1.36604

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Section

Original Articles