Effect of 72-hour versus weekly changes of in-line suction catheters on rates of ventilator-associated pneumonia

Abstract

© Journal Of The Medical Association Of Thailand. Background: Various studies have demonstrated that these two suction systems were not significantly different in the incidence of ventilator-associated pneumonia (VAP) and mortality rate among the mechanically ventilated patients. Closed suction system provided some benefits over open suction system, including shorter time of suction and fewer physiologic derangements. There is limited evidence regarding the interval changes of in-line suction catheter. Objective: To determine whether 3-day interval changes of in-line suction catheter affected the incidence of VAP compared to 7-day interval changes. Materials and Methods: The present study was a randomized controlled study. Mechanically ventilated medical patients admitted to intensive care unit were enrolled and randomized into two groups, group 1 with a 3-day interval changes of in-line suction catheter, and group 2 with a 7-day interval changes. Results: Two hundred six patients were randomized into group 1 (n=116) and group 2 (n=90). Demographic data showed no significant difference except for APACHE II score (18 and 20 in group 1 and 2, respectively; p=0.013). The incidence of VAP in the present study was 18.9%, which was not different between the two groups using non-inferiority test (15.5% and 23.3%, respectively; p<0.002). Patients in group 2 had significant higher all-cause mortality compared to patients in group 1. The authors estimated that 7-day interval change of suction catheter will result in a cost-savings of 1,195 baht per person per day. Conclusion: In comparison with 3-day interval changes of in-line suction catheter, the 7-day interval changes was not associated with higher incidence of VAP and resulted in cost savings without an increase rate of early replacement of suction catheter. However, the effect on all-cause mortality cannot be concluded from the present study.