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KMID : 1033320130030010018
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Global Health & Nursing
2013 Volume.3 No. 1 p.18 ~ p.27
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Subglottic Secretion Drainage for the Prevention of Ventilator associated Pneumonia: A Meta-analysis
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Kim Hyun-Hee
Kim Jung-Soon
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Abstract
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Purpose: To assess the efficacy of subglottic secretion drainage in preventing ventilator associated pneumonia.
Methods: We included randomized clinical trials of mechanically ventilated patients that had compared with standard endotracheal tube care and subglottic secretion drainage. We identified eight randomized clinical trials that met the inclusion criteria with a total of 2112 randomized patients. Studies were meta-analyzed by Review Manager 5.1.
Results: The overall risk ratio for ventilator-associated pneumonia of subglottic secretion drainage was 0.55 (95% CI: 0.44~0.70; p<.001) with no heterogeneity (p=.41; I²=2%). There was no effect on hospital (RR=0.93; 95% CI: 0.76~1.13; p=.45) or intensive care unit (RR=1.04; 95% CI: 0.86~1.24; p=.71) mortality. Both intermittent subglottic secretion drainage (RR=0.47; 95% CI: 0.34~0.64; p<.001) and continuous subglottic secretion drainage (RR=0.69; 95% CI: 0.49~0.97; p=.03) was effective in the reduction of ventilator associated pneumonia.
Conclusion: Subglottic secretion drainage is effective for the prevention of ventilator-associated pneumonia. However clinicians must take effectiveness and safety into consideration at the same time, applying subglottic secretion drainage.
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KEYWORD
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Subglottic secretion drainage, Ventilator-associated pneumonia, Prevention, Meta-analysis
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