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Erschienen in:
01.02.2004 | Original
Airway colonisation in long-term mechanically ventilated patients
Effect of semi-recumbent position and continuous subglottic suctioning
Erschienen in: Intensive Care Medicine | Ausgabe 2/2004
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Objective
To evaluate the impact of continuous subglottic suctioning and semi-recumbent body position on bacterial colonisation of the lower respiratory tract.
Design
A randomised controlled trial.
Setting
The ten-bed medical ICU of a French university hospital.
Patients
Critically ill patients expected to require mechanical ventilation for more than 5 days.
Interventions
Patients were randomly assigned to receive either continuous suctioning of subglottic secretions and semi-recumbent body position or to receive standard care and supine position.
Measurements and results
Oropharyngeal and tracheal secretions were sampled daily and quantitatively cultured. All included patients were followed up from day 1 (intubation) to day 10, extubation or death. Ninety-seven samples of oropharynx and trachea were analysed (40 for the suctioning group and 57 for the control group). The median bacterial counts in trachea were 6.6 Log10 CFU/ml (interquartile range, IQR, 4.4–8.3) in patients who received continuous suctioning and 5.1 Log10 CFU/ml (IQR 3.6–5.5) in control patients. Most of the patients were colonised in the trachea after 1 day of mechanical ventilation (75% in the suctioning group, 80% in the control group). No significant difference was found in the daily bacterial counts in the oropharynx and in the trachea between the two groups of patients.
Conclusion
Tracheal colonisation in long-term mechanically ventilated ICU patients was not modified by the use of continuous subglottic suctioning and semi-recumbent body position.