DOI: 10.36347/sjams.2021.v09i04.002

Pages: 506-511

Background: Ventilator-associated pneumonia (VAP) is the leading healthcare-acquired infection (HAI) among mechanically ventilated patients in intensive care units (ICU). The influence of subglottic secretion drainage (SSD) in reducing VAP remains controversial. Aim and Objective: This prospective study was intended to find the effectiveness of endotracheal tube (ETT) with subglottic suction device (for intermittent subglottic secretion drainage) in reducing the risk of VAP. Study Design: Prospective observational study. Patients & Methods: The study consecutively included 42 adult patients on mechanical ventilation from ICU Unit of BSMMU, Dhaka during the study period. Patients were divided into two groups one with endotracheal tube with subglottic suction device (SSD) (Group-A, n = 21) and another with conventional endotracheal tube (Group-B, n = 21). Data were collected by taking detailed history, clinical examination, investigation including tracheal aspirate culture to find the presence or absence of ventilator-associated pneumonia (VAP) on ventilated patients. The incidence of VAP was compared between the Group-A and Group-B and the relative risk (RR) of developing VAP in patients with SSD were calculated. Results: The Group-A and Group-B were almost alike in terms of demographic characteristics (age and sex). Smoking habit was almost identical between groups. Reason of ICU admission was no different between groups (p = 0.263). The average duration of mechanical ventilation was also statistically similar. Associated co-morbidities were also similar in distribution between groups. Six out of 21(28.6%) patients in the Group-A and 12(57.1%) out of 21 patients in the Group-B developed VAP. The risk of developing VAP in the Group-A was calculated to be 0.53 or 53% (95% CI = .25 – 1.09) less compared to that in the Group-B. (p = 0.061). Of the 6 patients who developed VAP in the Group-A 4 (66.7%) had late VAP and the rest early VAP, but in the Group-B out of 12 pati