Effects of subglottic secretion drainage at different intervals on ventilator-associated pneumonia / 中国实用护理杂志

ABSTRACT

Objective To investigate the effects of subglottic secretion drainage at different intervals on ventilator- associated pneumonia(VAP). Methods A total of 150 patients receiving tracheostomy during January 2015 to December 2016 were divided into A, B, C group according to the order of intubation time. The subglottic secretion drainage was attracted at intervals of 2, 4, and 6 h respectively.The differences in balloon secretion on occult blood test(after intubation,intubation time,3 d, 5 d,7 d), the content of airborne bacteria in the air sac, the number of VAP and the time of VAP occurrence between the 3 groups were analyzed. Results The 3 groups that group A had 78 positive cases,group B had 46 cases and group C had 38 cases had statistical significance differences compared with balloon retentate occult blood test(χ2=28.23,P=0.00);there were statistical significance differences between the 3 groups of bacteria (Z=11.91, P =0.00 ), there were statistically significant differences between group A and group C (Z=-3.01, P=0.00), between group B and group C (Z=-2.19, P=0.01). There were statistical significance differences between the 3 groups of the number of VAP cases(χ2=7.50, P =0.00) that there were 12 cases happening in group A, 13 cases in group B and 23 cases in group C. There were statistical significance differences between group A and group C(χ2=5.32,P=0.02),between group B and group C (χ2=4.34, P =0.04). The occurrence time of VAP which was (169.25 ± 20.80) h in group A,(168.35±18.04)h in group B and(129.47±18.13)h in group C,there was significantly different between the 3 groups(F=2 788.19,P=0.00),the differences between group A and group C(t=3.19,P=0.00),group B and group C(t=68.40,P=0.00)were statistically significant. Conclusions The subglottic secretion drainage at intervals of 4 hours will not only reduce the damage to the airway mucosa,but also reduce the incidence of airway bacteria and the incidence of VAP and delay the occurrence of late VAP.