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标准气管插管与带持续声门下吸引的气管插管对呼吸机相关性肺炎发生率的比较效果

Comparative effectiveness of standard endotracheal tubes vs. endotracheal tubes with continuous subglottic suctioning on ventilator-associated pneumonia rates.

作者信息

Speroni Karen Gabel, Lucas Joy, Dugan Lisa, O'Meara-Lett Mildred, Putman Marissa, Daniel Marlon, Atherton Martin

机构信息

Inova Loudoun Hospital, Leesburg, VA, USA.

出版信息

Nurs Econ. 2011 Jan-Feb;29(1):15-20, 37.

Abstract

Ventilator-associated pneumonia (VAP) accounts for the majority of nosocomial pneumonias, which may increase intensive care and prolonged hospital stays. Endotracheal tubes allowing continuous subglottic suctioning may reduce VAP; however, they are more expensive than standard endotracheal tubes not allowing continuous suctioning. he objective of this study was to measure the comparative costs associated with continuous subglottic suctioning endotracheal tubes (CSS-ETT) versus standard endotracheal tubes (S-ETT) among intubated patients and whether cost differential is offset by the occurrence of VAP in patients receiving either type of intubation. A retrospective chart review was conducted for 154 intubated adult patients (77 = S-ETT; 77 = CSS-ETT). The S-ETT group had one case of VAP; the CSS-ETT group had none. The mean total hospital charges were higher for the S-ETT group ($103,600; CSS-ETT= $88,500) (p = 0.3). Although the average number of intubation days and ICU days were greater for the CSS-ETT group, there were no cases of VAP compared to the S-ETT group. ased upon the one S-ETT VAP case and the VAP attributable costs, it is cost effective to use the CSS-ETT.

摘要

呼吸机相关性肺炎(VAP)占医院获得性肺炎的大多数,这可能会增加重症监护时间和延长住院时间。允许持续声门下吸引的气管内导管可能会降低VAP的发生率;然而,它们比不允许持续吸引的标准气管内导管更昂贵。本研究的目的是衡量插管患者中使用持续声门下吸引气管内导管(CSS-ETT)与标准气管内导管(S-ETT)的相关成本比较,以及在接受这两种插管方式的患者中,VAP的发生是否会抵消成本差异。对154例成年插管患者(77例使用S-ETT;77例使用CSS-ETT)进行了回顾性病历审查。S-ETT组有1例VAP;CSS-ETT组无VAP病例。S-ETT组的平均总住院费用更高(103,600美元;CSS-ETT组为88,500美元)(p = 0.3)。尽管CSS-ETT组的平均插管天数和ICU天数更多,但与S-ETT组相比没有VAP病例。基于1例S-ETT VAP病例和VAP相关成本,使用CSS-ETT具有成本效益。

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