Effect of intermittent irrigation combined with continuous aspiration of subglottic secretion on the prevention of ventilator-associated pneumonia

Objective To evaluate the effect of intermittent irrigation combined with continuous aspiration of subglottic secretion on the prevention of ventilator-associated pneumonia(VAP).Methods Sixty ICU patients with mechanical ventilation were divided into 3 groups,20 cases in each group.The patients in group A received continuous aspiration of subglottic secretion;the patients in group B received intermittent irrigation combined with continuous aspiration of subglottic secretion;the patients in group C received conventional treatment.The specimen of respiratory tract secretion and residual subglottic secretion were taken for bacterial culture at 50 hours,4 days and 7 days after mechanical ventilation.Moreover,the incidence of VAP,the volume of subglottic drainage and the incidence of obstruction of drainage tube were recorded.Results The total incidence of VAP and incidence of VAP at 4 days after mechanical ventilation in group A was 38.9% and 16.7%,respectively;33.3% and 11.1% in group B;73.7% and 47.4% in group C.The volume of subglottic drainage in group B was significantly higher than group A and group C.The incidence of obstruction of the drainage tube was 27.8%,42.1% and zero in group A,group C and group B,respectively.Conclusion Intermittent subglottic irrigation combined with continuous aspiration of subglottic secretion can maintain the subglottic drainage unobstructed,reduce the incidence of obstruction of drainage tube and VAP.