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Comparative Evaluation of the Incidence of Ventilator Associated Pneumonia in Intermittent Oral Suction Vs Continuous Subglottic Suction in Adult Neurosurgical Patient Requiring Mechanical Ventilation: A Randomized Control Trial

Preeti Gehlaut, Assistant Professor, Department of Anaesthesiology and Critical Care, PGIMS, Rohtak, Haryana 124001, India. , Jyoti Sharma1 , Mohandeep Kaur2 , Haramritpal Kaur3 , Amiya Ranjan Patnaik4 , Pankaj Kumar Sharma5 , Preeti Gehlaut1

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Indian Journal of Anesthesia and Analgesia 4(4):p 1170-1175, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.41

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Abstract

Introduction: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs). The impaired host defenses and continuous exposure of the lower respiratory tract to large number of

pathogens through the endotracheal tube makes the mechanically ventilated patient prone to developing VAP. Thus present study was planned to compare the incidence of VAP in neurosurgical patients with continuous subglottic suction and conventional intermittent oral suction. Material and methods: A total of 70 adult neurosurgical patients who were expected to require mechanical ventilation for more than 72 hours were enrolled in this prospective study. These patients were randomized into two groups of 35 each. In group 1 patient were intubated with the conventional endotracheal tube and intermittent oral suction was done every 4 hourly and as and when required in addition. In group 2 the patients were intubated with Evac tube and continuous suctioning was done by maintaining a negative pressure of 20- 25 mm Hg. Both the groups were compared for the incidence of VAP. Results: Both the groups were comparable with regard to age and sex distribution. The incidence of VAP was 17.1% in patients of control group and 11.4% in patients of study group. There was an overall reduction in the incidence of VAP by 5.7% by the use of continuous subglottic suction the reduction. Conclusion: As the result shows 5.7% better outcome in study group as compared to control group, therefore the intervention used in the study group i.e. continuous subglottic suction is better than that used in control group i.e. intermittent oral suction.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.41

Keywords

Ventilator Associated Pneumonia; Continuous Subglottic Suction; Hi-Lo Evac Tube. 

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