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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Autores principales:	Lucyna Tomaszek, Jarosław Pawlik, Henryk Mazurek, Wioletta Mędrzycka-Dąbrowska
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	patient care bundles taper-shaped cuff subglottic secretion suction continuous control pressure Medicine R
Acceso en línea:	https://doaj.org/article/4cc29713ba4b49afa29241a3b8e97cd9
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spelling	oai:doaj.org-article:4cc29713ba4b49afa29241a3b8e97cd92021-11-11T17:35:14ZAutomatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort Study10.3390/jcm102149522077-0383https://doaj.org/article/4cc29713ba4b49afa29241a3b8e97cd92021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4952https://doaj.org/toc/2077-0383The 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.Lucyna TomaszekJarosław PawlikHenryk MazurekWioletta Mędrzycka-DąbrowskaMDPI AGarticlepatient care bundlestaper-shaped cuffsubglottic secretion suctioncontinuous control pressureMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4952, p 4952 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	patient care bundles taper-shaped cuff subglottic secretion suction continuous control pressure Medicine R
spellingShingle	patient care bundles taper-shaped cuff subglottic secretion suction continuous control pressure Medicine R 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
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.
format	article
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
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_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_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_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
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/4cc29713ba4b49afa29241a3b8e97cd9
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Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients—A Retrospective and Prospective Cohort Study

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