Chest
Original ResearchPneumoniaContinuous Aspiration of Subglottic Secretions in the Prevention of Ventilator-Associated Pneumonia in the Postoperative Period of Major Heart Surgery
Section snippets
Hospital Setting and Patients
Our institution is a general reference hospital with 1,750 beds and 64,000 admissions per year. The study population included patients who underwent MHS from May 2004 to July 2006. Patients who gave their informed consent were randomly assigned to receive either conventional respiratory care or CASS. Informed consent was obtained by the anesthesiologist in charge in all cases. Our Ethics Committee approved the study. An infectious diseases physician who was aware of the treatment assignments
Study Population
Overall, 1,101 patients underwent MHS during the study period. Of them, 387 patients were excluded either because they did not give their consent (268 patients) or the consent could not be requested due to the emergent condition of the surgery (119 patients). Accordingly, 714 patients undergoing MHS were randomized immediately before undergoing anesthesia (24 patients were excluded from the study; CASS group, 359 patients; control group, 331 subjects). The exclusions were due to death during
Discussion
We found that using CASS in patients undergoing MHS is a safe procedure that significantly reduces the antibiotic burden. In the population that was at high risk (ie, those persons receiving MV for > 48h), CASS reduced the incidence and incidence density of VAP. It also reduced ICU stay, duration of MV, and antibiotic consumption.
VAP is a very severe disease that is associated with a high degree of mortality, and few of the variables influencing mortality can be modified.30, 31, 32, 33, 34, 35,
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Cited by (0)
This research was supported in part by Ciber de Enfermedades Respiratorias (CIBERES) and by the Rafael del Pino Foundation.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).