Efficacy of Intermittent and Continuous Subglottic Secretion Drainage in Ventilator-Associated Pneumonia Reduction among Critically Ill Ventilated Patients: An Integrative Review
Journal Title: Saudi Journal of Medical and Pharmaceutical Sciences - Year 2017, Vol 3, Issue 5
Abstract
Abstract: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in critical care settings and affects between 9%-27% of mechanically ventilated patients for more than 48 or 72 hours. One of the strategies that reduce the VAP incidence is subglottic secretion drainage (SSD) through a lumen attached to a specialised endotracheal tube.This integrative review aims to investigate the efficacy of intermittent and continuous SSD in reducing VAP among critically ill ventilated patients. A systematic electronic search was conducted via CINAHL, PUBMED, MEDLINE and COCHRANE using the key terms. A manual search was also conducted through the references of retrieved studies, Scopus, and Google Scholar. Sixteen relevant primary articles were identified; twelve studies were conducted on general ICU populations examining intermittent subglottic drainage (ISD) and continuous aspiration of subglottic secretions (CASS) while four other studies were undertaken in cardiothoracic ICUs investigating CASS. No studies were found concerning the efficacy of ISD in this setting. Current evidence has revealed that ISD and CASS appear to be effective in general ICU settings while CASS did show significant reduction among the cardiothoracic ICU population. It was found that ISD appears to be safer in terms of tracheal damage despite the concerns of secretion pooling. This integrative review concluded that ISD and CASS appears to be effective methods in reducing VAP incidence among general ICU populations. Further research is needed to investigate both methods among cardiothoracic patients. A large randomised controlled trial is also required to compare the two settings and to determine the optimal frequency and suction pressure that could minimise complications. Keywords: Subglottic secretion drainage, ventilator-associated pneumonia, critically ill ventilated patients
Authors and Affiliations
Abdulmohsen Mohammed Folos, Mohammed Ageel Ahmed, Jubran Ali Sahli, Bander Mohammed Gohal, Ahmed Atyah Najmi, Ibrahim Mohammed Muallim, Ali Mohammed Abu Tawil
Keywords
Related Articles
- EP ID EP391003
- DOI -
- Views 90
- Downloads 0
Widespread and Fungating Kaposi Sarcoma in an HIV Negative Patient
Abstract: Kaposi sarcoma (KS) is a vascular neoplasm of the endothelial cells that commonly occurs in conditions that may lead to severe immunosuppression, e.g. HIV/AIDS, malignancies or use of immune suppressing medicat...
CymbopogoncitratusStapf(DC) extracts alleviate gasoline vapour-induced metabolic disorders and cardiovascular disease risk in rats
Abstract: Alternative therapies for the alleviation of chemical/xenobiotic-induced metabolic aberrations and risk factors for cardiovascular disease have been inadequately explored, despite their rich cardiovascula...
Interaction of ferrous gluconate with dextromethorphan, guaifenesin and caffeine and its application in bio-studies
Abstract: UV spectroscopy shows that dextromethorphan, guaifenesin and caffeine bind to ferrous gluconate, causing their spectra to shift. From this change, it is calculated that the binding energy is in the order of caf...
Appendicular Abscess to Streptococcus constellatus : Case Report
Abstract: Streptococcus constellatus is a germ that belongs to the Streptococcus millerigroup, it has a particular tropism for the digestive tract and the hepatobiliary region. It is found in deep abscesses in immunocomp...
Alterations in glutamate metabolism in rat brain by tramadol analgesia during non-induction of pain
Abstract: The objective of this study was to evaluate the effects of tramadol, a centrally acting synthetic opioid analgesic, on glutamate metabolism, without inducing pain. Male adult Wistar rats weighing 150 ± 20 g wer...