Is continuous subglottic suctioning cost-effective for the prevention of ventilator-associated pneumonia?
Infect Control Hosp Epidemiol
; 32(2): 131-5, 2011 Feb.
Article
em En
| MEDLINE
| ID: mdl-21460467
ABSTRACT
OBJECTIVE:
To establish whether continuous subglottic suctioning (CSS) could be cost-effective.DESIGN:
Cost-benefit analysis, based on a hypothetical replacement of conventional ventilation (CV) with CSS.SETTING:
A surgical intensive care unit (SICU) of a tertiary care university hospital in France. PATIENTS All consecutive patients receiving ventilation in the SICU in 2006.METHODS:
Efficacy data for CSS were obtained from the literature and applied to the SICU of our hospital. Costs for CV and CSS were provided by the hospital pharmacy; costs for ventilator-associated pneumonia (VAP) were obtained from the literature. The cost per averted VAP episode was calculated, and a sensitivity analysis was performed on VAP incidence and on the number of tubes required for each patient.RESULTS:
At our SICU in 2006, 416 patients received mechanical ventilation for 3,487 ventilation-days, and 32 VAP episodes were observed (7.9 episodes per 100 ventilated patients; incidence density, 9.2 episodes per 10,000 ventilation-days). Based on the hypothesis of a 29% reduction in the risk of VAP with CSS than CV, 9 VAP episodes could have been averted. The additional cost of CSS for 2006 was estimated to be 10,585.34. The cost per averted VAP episode was 1,176.15. Assuming a VAP cost of 4,387, a total of 3 averted VAP episodes would neutralize the additional cost. For a low VAP incidence of 6.6%, the cost per averted VAP would be 1,323. If each patient required 2 tubes during ventilation, the cost would be 1,383.69 per averted VAP episode.CONCLUSION:
Replacement of CV with CSS was cost-effective even when assuming the most pessimistic scenario of VAP incidence and costs.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Sucção
/
Controle de Doenças Transmissíveis
/
Pneumonia Associada à Ventilação Mecânica
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Intubação Intratraqueal
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article