Major articleSubglottic secretion drainage and continuous control of cuff pressure used together save health care costs
Section snippets
Study design
A prospective observational study with an incidental sample of 656 patients was performed at the 24-bed medical-surgical intensive care unit (ICU) of the University Hospital of the Canary Islands, a 650-bed tertiary hospital, over a 1-year period. The study was approved by the hospital's Institutional Ethics Review Board. Informed consent was obtained from all patients or legal guardians. The inclusion criterion was the need for mechanical ventilation.
VAP prevention measures
The following endotracheal tubes were used:
Results
Our study cohort comprised 656 patients, including 241 with intermittent control of cuff pressure and without SSD (standard group), 260 with continuous control of cuff pressure and without SSD (CCCP group), 84 with intermittent control of cuff pressure and with SSD (SSD group), and 71 with continuous control of cuff pressure and with SSD (CCCP + SSD group) (Table 1).
The incidence of VARI was lower in the CCCP + SSD group compared with the standard group (P < .001), CCCP group (P = .006), and
Discussion
To our knowledge, this is the first study to report that the combined use of an endotracheal tube with a lumen for SSD and a continuous cuff pressure control system can reduce health care costs. We found that the use of an endotracheal tube with a small-bore lumen for SSD exerted a protective effect against VARI, a finding consistent with the results of previous studies.7, 8, 9, 10
In addition, we found that the use of a CCCP system reduced the risk of VARI. This finding is in agreement with the
Conclusion
The combined use of subglottic secretion drainage and continuous control of endotracheal tube cuff pressure decreased the incidence of VARI and reduced health care costs in our study population.
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Supported in part by grants from the Instituto de Salud Carlos III (I3SNS- INT-11-063 and I3SNS-INT-12-087) and the Fondo Europeo de Desarrollo Regional.
Conflict of interest: None to report.