SUBGLOTTIC AND CLOSED ENDOTRACHEAL SUCTIONING VERSUS OPEN ENDOTRACHEAL SUCTIONING-EFFECT ON VENTILATOR-ASSOCIATED PNEUMONIA RATES AND LENGTH OF INTENSIVE CARE UNIT STAY

BACKGROUND Ventilator Associated Pneumonia (VAP) is a complication of invasive mechanical ventilatory support. One of the methods of preventing VAP is adequate suctioning. This study compared the incidence of VAP and length of Intensive Care Unit (ICU) stay among patients managed by two different suctioning techniques, grouped as Group OES and Group SS + CES. Group OES patients were managed by Open Endotracheal Suctioning. Group SS + CES patients were managed by subglottic suctioning and closed endotracheal suctioning. MATERIALS AND METHODS Patients in Group OES (n= 20) were intubated with conventional ETT and those in Group SS + CES (n= 20) with ETT having subglottic suction port above the cuff. VAP was defined as a Clinical Pulmonary Infection Score of > 6 with a positive quantitative endotracheal culture in patients on ventilator for > 48 h. Chi-square test and Mann-Whitney U-test were performed for statistical analysis. RESULTS Nine patients in Group OES and three patients in Group SS + CES developed VAP. VAP rate was significantly lesser in patients intubated with ETT having subglottic suction port above the cuff and managed by subglottic and closed endotracheal suctioning. ICU stay was significantly lesser in Group SS + CES (median, 6 days; interquartile range: 5 - 7) compared to patients in Group OES (median, 7; interquartile range: 6 - 9). CONCLUSION The VAP rate and length of ICU stay were significantly lesser among patients intubated with the ETTs having subglottic suction port above the cuff and managed by subglottic suctioning and closed endotracheal suctioning.