Prevention Ventilator Associated Pneumonia

Preventing Ventilator Associated Pneumonia

One of the most commonly occurring infections among patients hospitalized in intensive care units is ventilator-associated pneumonia, which is associated with several negative outcomes. This infection has generated considerable concerns among healthcare providers because it leads to protracted hospital stay, increased costs of healthcare services, and high mortality rate of between 15 and 45%. The infection also generates numerous complications for these patients, particularly those undergoing a major heart surgery that needs mechanical ventilation in the treatment process. Given these negative outcomes and increased concerns, prevention of ventilator-associated pneumonia is increasingly important in intensive care units. While several methods have been suggested to help prevent this infection, the use of endotracheal tube with subglottic suction line would help prevent VAP.

Using Endotracheal Tube with Subglottic Suction Line to Prevent VAP

As previously indicated, the use of endotracheal tube with subglottic suction line seems to be the most effective way of preventing ventilator-associated pneumonia. The use of this mechanism to prevent the infection is on the premise that aspiration of subglottic secretions (ASS) has proven beneficial in preventing VAP. Moreover, the findings of a meta-analysis on the issue have shown that ASS lessens the number of days a patient is on mechanical ventilation and the overall duration in intensive care units (Granda et al., 2013, p.312). The study has also shown that using ASS systematically in ICU patients undergoing major heart surgery lessens the frequency and density of ventilator-associated pneumonia. While this process lessens cost of antimicrobials, it increases the costs of endotracheal tubes that are required for conducting aspiration of subglottic secretions systematically. This is a significant indicator of the significance of endotracheal tubes with subglottic suction line in preventing VAP since the rate of this infection among patients going through major heart surgery is usually high. The high rate of VAP frequency among these patients is attributable to the fact that their preoperative, intraoperative, and postoperative factors associated with their condition increased the need for mechanical ventilation, which in turn contributes to the infection.

Endotracheal tube with subglottic suction line is vital in preventing the infection because it incorporates modifications of the tube to lessen microaspiration. This implies that including subglottic line in the endotracheal tube helps in reducing microaspiration or the formation of biofilm. The need for using these tubes with subglottic suction line is attributable to the fact that the buildup of subglottic secretions in the tube cuff enhances the risk of this infection. This is primarily because the subglottic secretions may seep out around the cuff of the endotracheal tube and generate aspiration as well as an enhanced risk of or vulnerability to VAP. Given this fact, the most suitable means for prevention of the infection is through removing subglottic secretion in the endotracheal tube. While there is relatively minimal study on secretion removal, existing studies demonstrate that subglottic suction line in these tubes help in effective removal of subglottic secretion, which in turn lessens the incident rate of the infection. Actually, removal of subglottic secretion in endotracheal tubes increases with tubes that have more subglottic suction tubing, suction port diameter, and dorsal lumen (Amato, 2011).