Is Continuous Subglottic Suctioning Cost-Effective for the Prevention of Ventilator-Associated Pneumonia?

Abstract

Replacement of CV with CSS was cost-effective even when assuming the most pessimistic scenario of VAP incidence and costs.

Measures to prevent nosocomial infections during mechanical ventilation

“…As well as being clinically effective, subglottic aspiration was cost-effective, even in intensive care units with low incidence of VAP [20]. One animal study showed diffuse damage of the mucosa secondary to aspiration [21].…”

Use of endotracheal tubes with subglottic secretion drainage reduces ventilator-associated pneumonia in trauma patients

“…21,22 However, since each episode of VAP costs an estimated $10,000 to $60,000, 23 the routine use of ETT-SSD has been shown not only to be cost-effective but also to produce significant savings. 21,24 Another argument against ETT-SSD is the potential for tracheal mucosal injury, but this has not been problematic when intermittent suction is used, as was done in our protocols. 22 The current study is limited by the retrospective design.…”

Endotracheal Tubes: Old and NewDiscussion

“…[147][148][149][150] For example, Shorr and O'Malley 147 calculated a net savings of $4,992 per VAP case, assuming that the SSD ETT was used on all nonelective intubations (irrespective of anticipated duration of ventilation); a VAP incidence of 25% in ; and a 30% relative risk reduction using SSD. A recent French study came to a similar conclusion using more conservative assumptions.…”

“…A recent French study came to a similar conclusion using more conservative assumptions. 148 Several evidence-based VAP prevention guidelines have already included SSD as a recommended strategy. [151][152][153][154][155] Hopefully, additional high-quality studies will evaluate SSD, and further system modifications can be made to ensure patient safety and tube functionality.…”