• Zunjia Wen, Haiying Zhang, Jianping Ding, Zhuo Wang, and Meifen Shen.
• Zunjia Wen is a registered nurse at The First Affiliated Hospital of Soochow University, Suzhou, China. Haiying Zhang is an associate professor at The First Affiliated Hospital of Soochow University, Suzhou, China. Jianping Ding is a registered nurse at The First Affiliated Hospital of Soochow University, Suzhou, China. Zhuo Wang is a registered nurse at The First Affiliated Hospital of Soochow University, Suzhou, China. Meifen Shen is a professor at The First Affiliated Hospital of Soochow University, Suzhou, China.
• Crit Care Nurse. 2017 Oct 1; 37 (5): e10-e17.

BackgroundVentilator-associated pneumonia is associated with high morbidity and mortality in patients receiving mechanical ventilation. Subglottic secretion drainage, which may be performed continuously or intermittently, is believed to be an effective strategy for coping with ventilator-assisted pneumonia. Whether continuous or intermittent subglottic secretion drainage is superior for preventing ventilator-assisted pneumonia remains unknown.MethodsThis study is a comprehensive, systematic meta-analysis of randomized trials comparing continuous and intermittent subglottic secretion drainage in patients receiving mechanical ventilation. Studies in English and Chinese published from January 1970 through November 2015 were identified by searching multiple databases. Summary risk ratios or weighted mean differences with 95% CIs were used to calculate each outcome by means of fixed- or random-effects models.ResultsEight studies enrolling a total of 1071 patients met the inclusion criteria. The summary risk ratio between continuous and intermittent subglottic secretion drainage for incidence of ventilator-assisted pneumonia was 0.83 (95% CI, 0.61-1.13); for time to ventilator-assisted pneumonia occurrence, 2.73 (95% CI, -0.39 to 5.85); for occult blood, 2.34 (95% CI, 0.25-21.88); for duration of mechanical ventilation, -0.89 (95% CI, -2.72 to 0.94); for length of intensive care unit stay, 3.98 (95% CI, -4.44 to 12.41); and for mortality, 0.80 (95% CI, 0.48-1.31).ConclusionsThe results indicate no apparent differences between continuous and intermittent subglottic secretion drainage for the treatment outcomes included in the analysis. Rigorously designed, large-scale randomized controlled trials are warranted to identify the roles of continuous and intermittent subglottic secretion drainage.©2017 American Association of Critical-Care Nurses.

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