HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (52) Citing Articles via Google Scholar Google Scholar Articles by Smulders, K. Articles by Vandenbroucke-Grauls, C. Search for Related Content PubMed PubMed Citation Articles by Smulders, K. Articles by Vandenbroucke-Grauls, C.

A Randomized Clinical Trial of Intermittent Subglottic Secretion Drainage in Patients Receiving Mechanical Ventilation^*

^* From the Departments of Medical Microbiology (Mr. Smulders and Dr. Weers-Pothoff) and Intensive Care (Dr. van der Hoeven), Bosch Medicentrum, ‘s-Hertogenbosch; and Department of Clinical Microbiology and Infection Control (Dr. Vandenbroucke-Grauls), "Vrije Universiteit" of Amsterdam, Amsterdam, the Netherlands.

Correspondence to: Kees Smulders, MA, Bosch Medicentrum, Deutersestraat 2, 5223 GV’s-Hertogenbosch, the Netherlands; e-mail: k.smulders{at}boschmedicentrum.nl

Objective: To study the effect of subglottic secretions drainage on the incidence of ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation.

Design: A randomized clinical trial.

Setting: A 12-bed general ICU.

Patients: One hundred fifty patients with an expected duration of mechanical ventilation > 72 h were enrolled in the study.

Intervention: Patients were randomly assigned to receive either an endotracheal tube for intermittent subglottic secretions drainage or a standard endotracheal tube.

Outcome measurements: Incidence of VAP, duration of mechanical ventilation, length of ICU stay, length of hospital stay, and mortality.

Results: Seventy-five patients were randomized to subglottic secretion drainage, and 75 patients were randomized to the control group. The two groups were similar at the time of randomization with respect to demographic characteristics and severity of illness. VAP was seen in 3 patients (4%) receiving suction secretion drainage and in 12 patients (16%) in the control group (relative risk, 0.22; 95% confidence interval, 0.06 to 0.81; p = 0.014). The other outcome measures were not significantly different between the two groups.

Conclusion: Intermittent subglottic secretion drainage reduces the incidence of VAP in patients receiving mechanical ventilation.

Key Words: aspiration • intubation • mechanical ventilation • subglottic secretion drainage • ventilator-associated pneumonia

This article has been cited by other articles:

				L. Lorente, S. Blot, and J. Rello Evidence on measures for the prevention of ventilator-associated pneumonia Eur. Respir. J., December 1, 2007; 30(6): 1193 - 1207. [Abstract] [Full Text] [PDF]

				S. M. Koenig and J. D. Truwit Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention Clin. Microbiol. Rev., October 1, 2006; 19(4): 637 - 657. [Abstract] [Full Text] [PDF]

				P. Dodek Improving patient safety in critical care: big challenge, exciting opportunity/L'amelioration de la securite des patients a l'unite des soins intensifs : un grand defi, une occasion stimulante Can J Anesth, May 1, 2005; 52(5): 459 - 462. [Full Text] [PDF]

				J. Mohr, M. Peninger, and L. Ostrosky-Zeichner Infection Control in Intensive Care Units Journal of Pharmacy Practice, April 1, 2005; 18(2): 84 - 90. [Abstract] [PDF]

				R. Gujadhur, B. W. Helme, A. Sanni, and J. Dunning Continuous subglottic suction is effective for prevention of ventilator associated pneumonia Interactive CardioVascular and Thoracic Surgery, April 1, 2005; 4(2): 110 - 115. [Abstract] [Full Text] [PDF]

				G. Chaiban, H. Hanna, T. Dvorak, and I. Raad A rapid method of impregnating endotracheal tubes and urinary catheters with gendine: a novel antiseptic agent J. Antimicrob. Chemother., January 1, 2005; 55(1): 51 - 56. [Abstract] [Full Text] [PDF]

				J. Ogata, K. Minami, H. Miyamoto, T. Horishita, M. Ogawa, T. Sata, and H. Taniguchi Gargling with povidone-iodine reduces the transport of bacteria during oral intubation: [Le gargarisme avec un melange de povidone-iode reduit le transport bacterien pendant l'intubation orale] Can J Anesth, November 1, 2004; 51(9): 932 - 936. [Abstract] [Full Text] [PDF]

				P. Dodek, S. Keenan, D. Cook, D. Heyland, M. Jacka, L. Hand, J. Muscedere, D. Foster, N. Mehta, R. Hall, et al. Evidence-Based Clinical Practice Guideline for the Prevention of Ventilator-Associated Pneumonia Ann Intern Med, August 17, 2004; 141(4): 305 - 313. [Abstract] [Full Text] [PDF]

				A. S. Michalopoulos, S. Geroulanos, and S. D. Mentzelopoulos Determinants of Candidemia and Candidemia-Related Death in Cardiothoracic ICU Patients Chest, December 1, 2003; 124(6): 2244 - 2255. [Abstract] [Full Text] [PDF]