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| Ventilator care bundle involving supra- and sub-glottic secretion drainage for preventing ventilator-associated pneumonia |
| Li Hu, Yang Chun-hui, Cui Yu-hui, Tang Jian-guo |
| Department of Emergency & Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China |
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Abstract Objective To evaluate the efficacy of ventilator care bundle involving supra- and sub-glottic secretion drainage（modified ventilator care bundle, mVCB）for preventing ventilator-associated pneumonia. Methods A retrospective chart review was performed for all mechanical ventilated patients（609 patients）in the Department of Emergency & Critical Care Medicine of Shanghai Fifth People's Hospital from January 2011 to December 2014 before and after a modified ventilator care bundle implementation. Data collected included age, gender, diagnosis, development, length of mechanical ventilation, length of hospital stay, length of ICU stay. Rate of VAP, length of mechanical ventilation, length of hospital stay and length of ICU stay were compared between before and after mVCB implementation andVAP and non-VAP patients. Results Kaplan-Meier survival analysis showed that mortality of VAP patients was significantly higher than patients without VAP（P＝0.0049）. Compared with patients before mVCB implementation, rate of VAP was significantly lower after mVCB implementation（10.8 per 1000 ventilator days versus 6.4 per 1000 ventilator days, P＝0.0348）. Moreover, patients after mVCB implementation had shorter length of hospital stay［（26.8±6.2）d vs.（28.6±9.6）d, P＝0.0078］and shorter length of ICU stay［（19.9±4.9）d vs.（21.3±7.5）d, P＝0.0063］. Multivariate regression analysis showed that mVCB was an independent variable that could reduce the development of VAP（OR 0.57, 95% CI0.33～0.97，P＝0.037）. Conclusion VAP was one major cause that could increase mortality of mechanical ventilated patients. mVCB implementation in mechanical ventilated patients could reduce the incidence of VAP, shorten length of mechanical ventilation, shorten length of hospital stay and ICU stay.
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Received: 27 February 2016
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Corresponding Authors:
Tang Jian-guo, E-mail: tangjianguo@5thhospital.com
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