Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort Study
The ventilator bundle consists of multiple methods to reduce ventilator-associated pneumonia (VAP) rates in Intensive Care Units (ICU). The aim of the study was to evaluate how the continuous automatic pressure control in tapered cuffs of endotracheal/tracheostomy tubes applied along with continuous...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/21/4952 |
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| author | Lucyna Tomaszek Jarosław Pawlik Henryk Mazurek Wioletta Mędrzycka-Dąbrowska |
| author_facet | Lucyna Tomaszek Jarosław Pawlik Henryk Mazurek Wioletta Mędrzycka-Dąbrowska |
| author_sort | Lucyna Tomaszek |
| collection | DOAJ |
| description | The ventilator bundle consists of multiple methods to reduce ventilator-associated pneumonia (VAP) rates in Intensive Care Units (ICU). The aim of the study was to evaluate how the continuous automatic pressure control in tapered cuffs of endotracheal/tracheostomy tubes applied along with continuous automatic subglottic secretion suction affect the incidence of VAP. In the prospective cohort (<i>n</i> = 198), the standard VAP bundle was modified by continuous automatic pressure control in taper-shaped cuff of endotracheal/tracheostomy tubes and subglottic secretion suction. VAP incidence, time to VAP onset, invasive mechanical ventilation days/free days, length of ICU stay, ICU mortality, and multidrug-resistant bacteria were assessed and compared to the retrospective cohort (<i>n</i> = 173) with the standard bundle (intermittent cuff pressure of standard cuff, lack of subglottic secretion suction). A smaller incidence of VAP (9.6% vs. 19.1%) and early onset VAP (1.5% vs. 8.1%) was found in the prospective compared to the retrospective cohort (<i>p</i> < 0.01). Patients in the prospective cohort were less likely to develop VAP (RR = 0.50; 95% CI: 0.29 to 0.85) and early-onset VAP (RR = 0.19; 95% CI: 0.05 to 0.64) and had longer time to onset VAP (median 9 vs. 5 days; <i>p</i> = 0.03). There was no significant difference (<i>p</i> > 0.05) between both cohorts in terms of invasive mechanical ventilation days/free days, length of ICU stay, ICU mortality and multidrug-resistant bacteria. Modification of the bundle for prevention of VAP can reduce early-onset VAP and total incidence of VAP and delay the time of VAP occurrence. |
| first_indexed | 2024-03-10T05:59:38Z |
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| id | doaj.art-4cc29713ba4b49afa29241a3b8e97cd9 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T05:59:38Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4cc29713ba4b49afa29241a3b8e97cd92023-11-22T21:05:06ZengMDPI AGJournal of Clinical Medicine2077-03832021-10-011021495210.3390/jcm10214952Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort StudyLucyna Tomaszek0Jarosław Pawlik1Henryk Mazurek2Wioletta Mędrzycka-Dąbrowska3Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Kraków, PolandFaculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Kraków, PolandDepartment of Pneumonology and Cystic Fibrosis, National Institute of Tuberculosis and Lung Disorders, 34-700 Rabka-Zdrój, PolandDepartment of Anesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdańsk, PolandThe ventilator bundle consists of multiple methods to reduce ventilator-associated pneumonia (VAP) rates in Intensive Care Units (ICU). The aim of the study was to evaluate how the continuous automatic pressure control in tapered cuffs of endotracheal/tracheostomy tubes applied along with continuous automatic subglottic secretion suction affect the incidence of VAP. In the prospective cohort (<i>n</i> = 198), the standard VAP bundle was modified by continuous automatic pressure control in taper-shaped cuff of endotracheal/tracheostomy tubes and subglottic secretion suction. VAP incidence, time to VAP onset, invasive mechanical ventilation days/free days, length of ICU stay, ICU mortality, and multidrug-resistant bacteria were assessed and compared to the retrospective cohort (<i>n</i> = 173) with the standard bundle (intermittent cuff pressure of standard cuff, lack of subglottic secretion suction). A smaller incidence of VAP (9.6% vs. 19.1%) and early onset VAP (1.5% vs. 8.1%) was found in the prospective compared to the retrospective cohort (<i>p</i> < 0.01). Patients in the prospective cohort were less likely to develop VAP (RR = 0.50; 95% CI: 0.29 to 0.85) and early-onset VAP (RR = 0.19; 95% CI: 0.05 to 0.64) and had longer time to onset VAP (median 9 vs. 5 days; <i>p</i> = 0.03). There was no significant difference (<i>p</i> > 0.05) between both cohorts in terms of invasive mechanical ventilation days/free days, length of ICU stay, ICU mortality and multidrug-resistant bacteria. Modification of the bundle for prevention of VAP can reduce early-onset VAP and total incidence of VAP and delay the time of VAP occurrence.https://www.mdpi.com/2077-0383/10/21/4952patient care bundlestaper-shaped cuffsubglottic secretion suctioncontinuous control pressure |
| spellingShingle | Lucyna Tomaszek Jarosław Pawlik Henryk Mazurek Wioletta Mędrzycka-Dąbrowska Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort Study Journal of Clinical Medicine patient care bundles taper-shaped cuff subglottic secretion suction continuous control pressure |
| title | Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort Study |
| title_full | Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort Study |
| title_fullStr | Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort Study |
| title_full_unstemmed | Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort Study |
| title_short | Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort Study |
| title_sort | automatic continuous control of cuff pressure and subglottic secretion suction used together to prevent pneumonia in ventilated patients a retrospective and prospective cohort study |
| topic | patient care bundles taper-shaped cuff subglottic secretion suction continuous control pressure |
| url | https://www.mdpi.com/2077-0383/10/21/4952 |
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