Open AccessInfluence of subglottic secretion drainage on the microorganisms of ventilator associated pneumonia
Author(s) -
Xu Huang,
Yan Du,
Bin Fu,
Liu Xia Li
Publication year - 2018
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000011223
Subject(s) - medicine , ventilator associated pneumonia , haemophilus influenzae , cochrane library , randomized controlled trial , pneumonia , meta analysis , microbiology and biotechnology , microorganism , gastroenterology , bacteria , antibiotics , biology , genetics
Background: The influence of the subglottic secretion drainage (SSD) on the microorganisms of ventilator associated pneumonia (VAP) is still unclear. A meta-analysis focusing on the influence of the SSD on the microorganisms of VAP. Methods: A comprehensive search was conducted through the online studies of PubMed, Embase, Cochrane Library, Google scholar, CNKI (China National Knowledge Infrastructure), and VIPI (Database for Chinese Technical Periodicals) using specific search terms. Included studies were randomized controlled trials (RCTs) that compare the microorganisms of VAP between SSD and standard endotracheal tube care in mechanically ventilated adults. Results: Nine RCTs were eligible. There was no significant difference in the rate of VAP caused by nonfermentative bacteria and enterobacteria between SSD group and control group (OR = 0.73, 95%CI, 0.53–1.01; P = .06). The episodes of VAP caused by Gram-positive cocci and Haemophilus influenzae organisms were lower in the SSD group (OR = 0.29, 95%CI, 0.18–0.48; P<0.00001). Less mean volume of SSD daily was observed in VAP group (OR = −16.97, 95%CI, −29.87–4.08; P = .010). Conclusion: We found SSD to be associated with significant decreases in VAP caused by Gram-positive cocci and H influenzae organisms but no significant differences in VAP caused by nonfermentative bacteria and enterobacteria. Less mean volume of SSD daily was observed in VAP group.