scholarly journals Subglottic Secretion Drainage to Prevent Ventilator-Associated Pneumonia in Mechanically Ventilated Adult Patients: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 24 (4) ◽  
Author(s):  
Farshid Rahimibashar ◽  
Zahra Farsi ◽  
Zahra Danial ◽  
Sahar Dalvand ◽  
Amir Vahedian-Azimi
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Adult Patients ◽  
Ventilator Associated Pneumonia ◽  
Mechanically Ventilated ◽  
Subglottic Secretion ◽  
Subglottic Secretion Drainage

Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: A systematic review and meta-analysis*

2011 ◽  
Vol 39 (8) ◽  
pp. 1985-1991 ◽  
Author(s):  
John Muscedere ◽  
Oleksa Rewa ◽  
Kyle Mckechnie ◽  
Xuran Jiang ◽  
Denny Laporta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Ventilator Associated Pneumonia ◽  
Subglottic Secretion ◽  
Subglottic Secretion Drainage

scholarly journals Subglottic secretion drainage for preventing ventilator-associated pneumonia: an overview of systematic reviews and an updated meta-analysis

2020 ◽  
Vol 29 (155) ◽  
pp. 190107 ◽  
Author(s):  
Diana P. Pozuelo-Carrascosa ◽  
Ángel Herráiz-Adillo ◽  
Celia Alvarez-Bueno ◽  
Jose Manuel Añón ◽  
Vicente Martínez-Vizcaíno ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Ventilator Associated Pneumonia ◽  
Effective Measure ◽  
Overview Of Reviews ◽  
Subglottic Secretion ◽  
Subglottic Secretion Drainage

Although several guidelines recommend subglottic secretion drainage as a strategy for prevention of ventilator-associated pneumonia (VAP), its use is not widespread. With the aim to assess the effectiveness of subglottic secretion drainage for preventing VAP and to improve other outcomes such as mortality, duration of mechanical ventilation and length of stay in the intensive care unit (ICU) or hospital, an electronic search of the Cochrane Library, MEDLINE, Web of Science and Embase was undertaken. Nine systematic reviews with meta-analysis (in the overview of reviews) and 20 randomised controlled trials (in the updated meta-analysis) were included.In the overview of reviews, all systematic reviews with meta-analysis included found a positive effect of subglottic secretion drainage in the reduction of incidence of VAP. In the updated meta-analysis, subglottic secretion drainage significantly reduced VAP incidence (risk ratio (RR) 0.56, 95% CI 0.48–0.63; I2=0%, p=0.841) and mortality (RR 0.88, 95% CI 0.80–0.97; I2=0%, p=0.888).This is the first study that has found a decrease of mortality associated with the use of subglottic secretion drainage. In addition, subglottic secretion drainage is an effective measure to reduce VAP incidence, despite not improving the duration of mechanical ventilation and ICU and/or hospital length of stay.

Subglottic secretion drainage for preventing ventilator-associated pneumonia: A meta-analysis

2005 ◽  
Vol 118 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Cameron Dezfulian ◽  
Kaveh Shojania ◽  
Harold R. Collard ◽  
H. Myra Kim ◽  
Michael A. Matthay ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Ventilator Associated Pneumonia ◽  
Subglottic Secretion ◽  
Subglottic Secretion Drainage

Subglottic secretion drainage for preventing ventilator associated pneumonia: A meta-analysis

2013 ◽  
Vol 26 (4) ◽  
pp. 180-188 ◽  
Author(s):  
Steven A. Frost ◽  
Azmeen Azeem ◽  
Evan Alexandrou ◽  
Victor Tam ◽  
Jeffrey K. Murphy ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Ventilator Associated Pneumonia ◽  
Subglottic Secretion ◽  
Subglottic Secretion Drainage

scholarly journals Subglottic secretion drainage for preventing ventilator associated pneumonia: A meta-analysis

2015 ◽  
Vol 2 (2-3) ◽  
pp. 55-60 ◽  
Author(s):  
Rong Wang ◽  
Xiang Zhen ◽  
Bao-Yi Yang ◽  
Xue-Zhen Guo ◽  
Xue Zeng ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Ventilator Associated Pneumonia ◽  
Subglottic Secretion ◽  
Subglottic Secretion Drainage

scholarly journals Diagnosis of ventilator-associated pneumonia in critically ill adult patients—a systematic review and meta-analysis

2020 ◽  
Vol 46 (6) ◽  
pp. 1170-1179 ◽  
Author(s):  
Shannon M. Fernando ◽  
Alexandre Tran ◽  
Wei Cheng ◽  
Michael Klompas ◽  
Kwadwo Kyeremanteng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Meta Analysis ◽  
Adult Patients ◽  
Ventilator Associated Pneumonia

scholarly journals Efficacy of Hi-Lo Evac Endotracheal Tube in Prevention of Ventilator-Associated Pneumonia in Mechanically Ventilated Poisoned Patients

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Ahmad Ghoochani Khorasani ◽  
Shahin Shadnia ◽  
Mohammad Mashayekhian ◽  
Mitra Rahimi ◽  
Abbas Aghabiklooei
Keyword(s):  
Endotracheal Tube ◽  
Control Group ◽  
Case Group ◽  
Ventilator Associated Pneumonia ◽  
Mechanically Ventilated ◽  
Subglottic Secretion ◽  
Icu Length Of Stay ◽  
Significant Difference ◽  
Subglottic Secretion Drainage ◽  
Health Care Associated Infection

Background. Ventilator-associated pneumonia (VAP) is the most common health care-associated infection. To prevent this complication, aspiration of subglottic secretions using Hi-Lo Evac endotracheal tube (Evac ETT) is a recommended intervention. However, there are some reports on Evac ETT dysfunction. We aimed to compare the incidence of VAP (per ventilated patients) in severely ill poisoned patients who were intubated using Evac ETT versus conventional endotracheal tubes (C-ETT) in our toxicology ICU.Materials and Methods. In this clinical randomized trial, 91 eligible patients with an expected duration of mechanical ventilation of more than 48 hours were recruited and randomly assigned into two groups: (1) subglottic secretion drainage (SSD) group who were intubated by Evac ETT (n=43) and (2) control group who were intubated by C-ETT (n=48).Results. Of the 91 eligible patients, 56 (61.5%) were male. VAP was detected in 24 of 43 (55.8%) patients in the case group and 23 of 48 (47.9%) patients in the control group (P=0.45). The most frequently isolated microorganisms wereS. aureus(54.10%) andAcinetobacterspp. (19.68%). The incidence of VAP and ICU length of stay were not significantly different between the two groups, but duration of intubation was statistically different and was longer in the SSD group. Mortality rate was less in SSD group but without a significant difference (P=0.68).Conclusion. The SSD procedure was performed intermittently with one-hour intervals using 10 mL syringe. Subglottic secretion drainage does not significantly reduce the incidence of VAP in patients receiving MV. This strategy appears to be ineffective in preventing VAP among ICU patients.

Preventing Ventilator-Associated Pneumonia in the United States: A Multicenter Mixed-Methods Study

2008 ◽  
Vol 29 (10) ◽  
pp. 933-940 ◽  
Author(s):  
Sarah L. Krein ◽  
Christine P. Kowalski ◽  
Laura Damschroder ◽  
Jane Forman ◽  
Samuel R. Kaufman ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Infection Control ◽  
Randomized Trials ◽  
Meta Analysis ◽  
The United States ◽  
Ventilator Associated Pneumonia ◽  
Subglottic Secretion ◽  
Staff Members ◽  
Subglottic Secretion Drainage ◽  
Va Hospitals

Objective.To determine what practices are used by hospitals to prevent ventilator-associated pneumonia (VAP) and, through qualitative methods, to understand more fully why hospitals use certain practices and not others.Design.Mixed-methods, sequential explanatory study.Methods.We mailed a survey to the lead infection control professionals at 719 US hospitals (119 Department of Veterans Affairs [VA] hospitals and 600 non-VA hospitals), to determine what practices are used to prevent VAP. We then selected 14 hospitals for an in-depth qualitative investigation, to ascertain why certain infection control practices are used and others not, interviewing 86 staff members and visiting 6 hospitals.Results.The survey response rate was 72%; 83% of hospitals reported using semirecumbent positioning, and only 21% reported using subglottic secretion drainage. Multivariable analyses indicated collaborative initiatives were associated with the use of semirecumbent positioning but provided little guidance regarding the use of subglottic secretion drainage. Qualitative analysis, however, revealed 3 themes: (1) collaboratives strongly influence the use of semirecumbent positioning but have little effect on the use of subglottic secretion drainage; (2) nurses play a major role in the use of semirecumbent positioning, but they are only minimally involved with the use of subglottic secretion drainage; and (3) there is considerable debate about the evidence supporting subglottic secretion drainage, despite a meta-analysis of 5 randomized trials of subglottic secretion drainage that generally supported this preventive practice, compared with only 2 published randomized trials of semirecumbent positioning, one of which concluded that it was ineffective at preventing the development of VAP.Conclusion.Semirecumbent positioning is commonly used to prevent VAP, whereas subglottic secretion drainage is used far less often. We need to understand better how evidence related to prevention practices is identified, interpreted, and used to ensure that research findings are reliably translated into clinical practice.

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