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Comparison of the Use of Conventional and Antibiotic-Coated Tracheal Tubes and EVAC on the Incidence of Ventilator-Associated Pneumonia (VAP)

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Open Journal of Emergency Medicine 2023年第3期11卷 45-56页

作者： Mehrdad Taghizadeh Amin Shams Akhtari Babak Heidariaghdam Seyedeh Hedieh Mousavipak siamak moghadamzadeh Mohammad Reza Haji Esmaili Faeze Vahid Department of Emergency Medicine Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Clinical Research Development Unit of Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Emergency Department of Hervey Bay Hospital Queensland Hervey Bay Australia Department of Cardiology Jam Hospital Tehran Iran Department of Basic Sciences Islamic Azad University Tehran Iran Department of Anesthesia Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Independent Researcher Tehran Iran

Ventilator-associated pneumonia (VAP) is one of the most important hospital infections in hospitalized patients, which is associated with increased mortality and patient costs. The tracheal tube itself seems to be a major risk factor for VAP. Contaminated secretions pass through the endotracheal tube and reach the lungs. Also, bacteria form a bacterial biofilm on the tracheal tube and are transferred from there to the lungs. Different tracheal tube designs have been produced to overcome these cases. The purpose of this study is to investigate the effect of an Evac tracheal tube covered with antibiotics and normal on the incidence of pneumonia caused by the ventilator. Research method: 180 patients were randomly intubated in three groups of 60 people with three types of tracheal tubes, Evac and Bactiguard. Clinical examinations, endotracheal tube aspiration culture, and chest radiography were obtained from the patients and the incidence of VAP was calculated based on the CPIS standard. The relationship between the type of endotracheal tube and the incidence of VAP and the length of stay in the intensive care unit (ICU) and being discharged alive from the ICU were investigated. Findings and conclusions: The average incidence of VAP for the group of patients intubated with a conventional tracheal tube was 50%, EVAC was 45% and Bactiguard was 40%. The results showed that there is no significant relationship between the incidence of ventilator-induced pneumonia and the type of tracheal tube. The incidence of ventilator-induced pneumonia was not significantly reduced by suctioning subglottic secretions and Bactiguard tracheal tubes. It seems that using one method alone is not effective in reducing ventilator-induced pneumonia.

关键词： Intensive Care Unit Pneumonia Suction Ventilator

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