• Hiroko Fujimoto, Osamu Yamaguchi, Hajime Hayami, Mika Shimosaka, Sayaka Tsuboi, Mitsunori Sato, Shigeo Takebayashi, Satoshi Morita, Mari Saito, Takahisa Goto, and Kiyoyasu Kurahashi.
• Division of Critical Care, Yokohama City University Medical Center, Minami-ku, Yokohama, Kanagawa 232-0024, Japan.
• Oncotarget. 2018 Mar 23; 9 (22): 15876-15882.

ObjectiveAspiration of subglottic secretion is a widely used intervention to prevent ventilator-associated pneumonia (VAP). This study aimed to compare the efficacy of continuous and intermittent subglottic secretion drainage (SSD) in preventing VAP.MethodsA single-center randomized controlled trial was conducted on adult postoperative patients who were expected to undergo mechanical ventilation for more than 48 hours. Primary outcome measure was incidence of VAP and secondary outcome measures were length of mechanical ventilation and intensive-care unit (ICU) stay.ResultsFifty-nine patients received continuous SSD, while 60 patients received intermittent SSD. Of these 119 patients, 88 (74%) were excluded and 15 and 16 patients were allocated to receive continuous and intermittent SSD, respectively. VAP was detected in 4 (26.7%) and 7 (43.8%) patients in the continuous and intermittent groups, respectively, (p=0.320). The length of mechanical ventilation was significantly shorter (p=0.034) in the continuous group (99.5±47.1 h) than in the intermittent group (159.9±94.5 h). The length of ICU stay was also shorter (p=0.0097) in the continuous group (6.3±2.1 days) than the intermittent group (9.8±4.8 days).ConclusionsAlthough continuous SSD did not reduce the incidence of VAP, it reduced the length of mechanical ventilation and ICU stay when compared to intermittent SSD.

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