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Did You Know?

Continuous subglottic suctioning and frequent intermittent subglottic suctioning drainage of subglottic secretions, via a cuffed endotracheal tube, are associated with up to a 50 percent decrease in the incidence of gastric aspiration, a potential cause of ventilator-associated pneumonia (VAP).¹

A 2011 systematic review of 13 trials found the use of subglottic secretion drainage endotracheal tubes contributed to the following benefits:²

• Reduction of VAP cases by 45 percent.
• Reduction in length of stay by 1.5 days.
• Reduction of time on ventilator by 1.1 days.

What the Evidence Says

Society for Healthcare Epidemiology of America

Recommends the use of cuffed subglottic secretion drainage endotracheal tube (SSD-ETT) with inline subglottic suction to prevent aspiration and reduce VAP risk factor.³

ZAP the VAP: Ventilator Associated Pneumonia

Subglottic secretion drainage is recommended for patients requiring mechanical ventilation for more than 72 hours.⁴

American Thoracic Society

Recommends the use of specifically designed SSD-ETT for the continuous aspiration of subglottic secretion.⁵

Centers for Disease Control and Prevention

Recommends the use of an SSD-ETT above the endotracheal cuff to allow drainage by continuous or frequent intermittent suctioning of tracheal secretion that accumulates in the patient’s subglottic area.⁶

References

1. Leasure A, Stirlen J, Lu S. Prevention of ventilator-associated pneumonia through aspiration of subglottic secretions: A systematic review and meta-analysis. Dimens Crit Care Nurs 2012;31(2):102-17. PMID: 22333720.
2. Muscedere J, Rewa O, McKechnie K, et al. Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: A systematic review and meta-analysis. Crit Care Med 2011 39(8):1985-91. PMID: 21478738.
3. Coffin S, Klompas M, Classen D, et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals: A compendium of strategies to prevent healthcare-associated infections in acute care hospitals. Infect Control 2008 Oct;29 Suppl 1:S31-S40. PMID: 18840087.
4. Muscedere J, Dodek P, Keenan S, et al. Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: Diagnosis and treatment. J Crit Care 2008 Mar;23(1):138-47. PMID: 18359431.
5. American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005 Feb 15;171(4):388-416. PMID: 15699079.
6. Tablan OC, Anderson LJ, Besser R, et al. Guidelines for preventing healthcare-associated pneumonia, 2003: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep 2004 Mar 26;53(RR-3):1-36. PMID: 15048056.