Intensive Care Medicine

, Volume 26, Issue 7, pp 878–882

Nosocomial pneumonia in mechanically ventilated patients, a prospective randomised evaluation of the Stericath closed suctioning system

  • P. Combes
  • B. Fauvage
  • C. Oleyer
ORIGINAL

Abstract

Objective: To compare the ventilator-associated pneumonia (VAP) incidence rates in mechanically ventilated patients according to the type of endotracheal suctioning (closed versus open). Setting: The Neurosurgery Intensive Care Unit of the Grenoble University Hospital, France. Design: A prospective randomised study performed after a 6-month period of nursing personnel training. Patients: One hundred four consecutive patients needing mechanical ventilation for more than 48 h were randomised into two groups. To be eligible, patients had to have no active infection or respiratory affection in their passes. In the Stericath group (S + , n = 54), patients were not disconnected from the ventilator during suctioning. The others were routinely managed (S–, n = 50). In both groups patterns of frequency and duration of suctioning were performed according to a standardised protocol.¶Measurements: The non-adjusted incidence rate of VAP was lower for S + than for S– (7.32 versus15.89 per 1000 patient-days, p = 0.07). Multivariate analysis performed using the Cox model showed an adjusted risk of VAP 3.5 times higher in S– (95 %Cl: 11.00–12.33). The risk being 4.3 higher in patients receiving gastric acid secretion inhibitors (1.08–16.82). In non-censored cases (n = 76) length of ICU stay increased by an average of 16.8 days when VAP was present (p = 0.0008). No adverse effect due to Stericath use was noted and volume of tracheal aspirate was similar between groups (p = 0.178). Conclusion: The use of Stericath reduced the incidence rate of VAP without demonstrating any adverse effect.

Key words Nosocomial pneumopathy Mechanical ventilation Cox model Closed suctioning device ICU 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • P. Combes
    • 1
  • B. Fauvage
    • 2
  • C. Oleyer
    • 2
  1. 1.Département d'Information Médicale et de Santé Publique, Centre Hospitalier de Roanne, 28 rue de Charlieu, B. P. 511, 42 300 Roanne, FranceFR
  2. 2.Réanimation de Neurochirurgie, C. H. U. de Grenoble, B. P. 217 Cedex 9, 38 043 Grenoble, France e-mail: BFauvage@chu-grenoble.fr Tel.: + 33-4-76 76 55 04 Fax: + 33-4-76 76 87 77FR

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