Prevention of nosocomial pneumonia in intubated patients: respective role of mechanical subglottic secretions drainage and stress ulcer prophylaxis.
Intensive Care Med
; 18(1): 20-5, 1992.
Article
em En
| MEDLINE
| ID: mdl-1578042
ABSTRACT
Chronic microaspiration through a tracheal cuff is the main culprit in the penetration and colonization of the lower respiratory tract. A total of 145 patients intubated for more than 3 days were randomly assigned to a double nosocomial pneumonia (NP) prevention 1--Prevention of aspiration by hourly subglottic secretion drainage (SSD) with a specific endotracheal tube (HI-LO Evac tube, Mallinckrodt); 2--Prevention of gastric colonization using either sucralfate or antacids. Four random groups were defined, similar in age and severity of illness. Subglottic secretion drainage treatment was associated with a) a twice lower incidence of NP (no-SSD 29.1%, SSD 13%); b) a prolonged time of onset of NP (no-SSD 8.3 +/- 5 days, SSD 16.2 +/- 11 days); c) a decrease in the colonization rate from admission to end-point day in tracheal aspirates (no-SSD +21.3%, SSD +6.6%) and in subglottic secretions (no-SSD +33.4%, SSD +2.1%). Sucralfate was not associated with a significantly lower incidence of NP (antacids 23.6%, sucralfate 17.8%), but with a lower increase in the colonization rate in subglottic and gastric aspirates, from admission to end-point day.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonia Aspirativa
/
Gastropatias
/
Sucção
/
Infecção Hospitalar
/
Infecções
/
Intubação Intratraqueal
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Intensive Care Med
Ano de publicação:
1992
Tipo de documento:
Article
País de afiliação:
França