Effect of different types of endotracheal tubes on ventilator-associated pneumonia / 中华急诊医学杂志

ABSTRACT

Objective To compare the clinical effect of conventional polyvinyl chloride (PVC) endotracheal tube with silicone wire reinforced endotracheal tube to prevent ventilator-associated pneumonia (VAP) in mechanical ventilation patients.Methods A total of 240 mechanical ventilation patients in the ICU were enrolled in this study,which were divided into two groups,PVC endotracheal intubation group (PVC group,n=1 13) and wire reinforced endotracheal intubation group (WR group,n=127).Gender,age,APACHE Ⅱ score,one-time success rate of intubation,intubation time,the rate of changing endotracheal,ventilation time,rate of tracheotomy and the incidence of VAP were compare between the two groups.Predictive factors for VAP were identified by the univariate and multivariate analyses in step-wise logistic regression model.Results The rate of changing endotracheal tube in the PVC group was lower than that in the WR group (x2=5.785,P=0.016);the mechanical ventilation time in the PVC group was shorter than that in the WR group (t=2.180,P=0.018);and compared with the WR group,the PVC group had significantly lower incidence of VAP (x2=6.215,P=0.012).The univariate analysis showed that the selection ofPVC endotracheal tube,APACHE Ⅱ score and mechanical ventilation time were the significant risk factors for VAP (P ＜ 0.05).Multivariate analysis showed that the different selection of endotracheal tube and mechanical ventilation time were independent influencing factors ofVAP (P ＜ 0.05).Conclusions PVC tracheal tube can effectively reduce the incidence of VAP in patients with mechanical ventilation.