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Clinical Investigations in Critical Care |

A Randomized Clinical Trial of Intermittent Subglottic Secretion Drainage in Patients Receiving Mechanical Ventilation*

Kees Smulders, MA; Hans van der Hoeven, MD, PhD; Ineke Weers-Pothoff, MD, PhD; Christina Vandenbroucke-Grauls, MD, PhD
Author and Funding Information

*From the Departments of Medical Microbiology (Mr. Smulders and Dr. Weers-Pothoff) and Intensive Care (Dr. van der Hoeven), Bosch Medicentrum, ‘s-Hertogenbosch; and Department of Clinical Microbiology and Infection Control (Dr. Vandenbroucke-Grauls), “Vrije Universiteit” of Amsterdam, Amsterdam, the Netherlands.

Correspondence to: Kees Smulders, MA, Bosch Medicentrum, Deutersestraat 2, 5223 GV’s-Hertogenbosch, the Netherlands; e-mail: k.smulders@boschmedicentrum.nl



Chest. 2002;121(3):858-862. doi:10.1378/chest.121.3.858
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Objective: To study the effect of subglottic secretions drainage on the incidence of ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation.

Design: A randomized clinical trial.

Setting: A 12-bed general ICU.

Patients: One hundred fifty patients with an expected duration of mechanical ventilation > 72 h were enrolled in the study.

Intervention: Patients were randomly assigned to receive either an endotracheal tube for intermittent subglottic secretions drainage or a standard endotracheal tube.

Outcome measurements: Incidence of VAP, duration of mechanical ventilation, length of ICU stay, length of hospital stay, and mortality.

Results: Seventy-five patients were randomized to subglottic secretion drainage, and 75 patients were randomized to the control group. The two groups were similar at the time of randomization with respect to demographic characteristics and severity of illness. VAP was seen in 3 patients (4%) receiving suction secretion drainage and in 12 patients (16%) in the control group (relative risk, 0.22; 95% confidence interval, 0.06 to 0.81; p = 0.014). The other outcome measures were not significantly different between the two groups.

Conclusion: Intermittent subglottic secretion drainage reduces the incidence of VAP in patients receiving mechanical ventilation.

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