Subglottic suction frequency and adverse ventilator-associated events during critical illness

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Abdallah, Hatem ; Weingart, Melanie F. ; Fuller, Risa ; Pegues, David ; Fitzpatrick, Rebecca ; Kelly, Brendan J.
• Description:
  Objective ; Tracheal intubation and mechanical ventilation provide essential support for patients with respiratory failure, but the course of mechanical ventilation may be complicated by adverse ventilator-associated events (VAE). VAE may be infection-associated or not. We sought to understand how the frequency of subglottic suction, an indicator of the quantity of sputum produced by ventilated patients, relates to onset of all VAE and infection-associated VAE. ; Design ; We performed a case-crossover study including 87 patients with VAE and evaluated 848 days in the pre-VAE period at risk for VAE. ; Setting & Participants ; Critically ill subjects were recruited from the medical intensive care unit of an academic medical center. ; Methods ; We used the number of as-needed subglottic suctioning events performed per calendar day to quantify sputum production and compared the immediate pre-VAE period to the preceding period. We used CDC surveillance definitions for VAE and to categorize whether events were infection-associated or not. ; Results ; Sputum quantity measured by subglottic suction frequency is greater in the period immediately prior to VAE, compared to the preceding period. However, it does not discriminate well between infection-associated VAE and VAE without associated infection. ; Conclusions ; Subglottic suction frequency may serve as a valuable marker of sputum quantity, and is associated with risk for VAE. However, our results require validation in a broader population of mechanically ventilated patients and intensive care settings.
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• Subjects:
  • Critical Illness
  • Cross-Over Studies
  • Humans
  • Intensive Care Units
  • Pneumonia, Ventilator-Associated
  • Respiration, Artificial
  • Suction
  • Ventilators, Mechanical
• Keywords:
  • ventilator-associated complications
  • ventilator-associated pneumonia
  • subglottic suction
• Source:
  Infect Control Hosp Epidemiol. 42(7):826-832
• Pubmed ID:
  33423714
• Pubmed Central ID:
  PMC8272736
• Document Type:
  Text
• Funding:
  K23 AI121485/AI/NIAID NIH HHSUnited States/ ; L30 AI120149/AI/NIAID NIH HHSUnited States/ ; U54 CK000485/CK/NCEZID CDC HHSUnited States/ ; U54CK000485/ACL/ACL HHSUnited States/
• Genre:
  Journal Article
• Volume:
  42
• Issue:
  7
• Download URL:
  https://stacks.cdc.gov/view/cdc/153694/cdc_153694_DS1.pdf
• File Type:
  [PDF - 1.15 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:b8ac2603afbe01139b1276608fff2b0a67a98ea7d04d579a2625deab7e17a475cb00133ca78433b4677a2b1aa81e0b29345df11476c90defbd4c2cecc6e10357