Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Ciber de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
J Hosp Infect. 2013 Dec;85(4):312-5. doi: 10.1016/j.jhin.2013.08.006. Epub 2013 Sep 14.
Aspiration of subglottic secretions (ASS) is recommended in patients requiring mechanical ventilation for ≥48h. We assessed the impact of the introduction of ASS routinely in all patients after major heart surgery in an ecological study comparing ventilator-acquired pneumonia (VAP) incidence, days of mechanical ventilation, and cost of antimicrobial agents before and after the implementation of ASS. Before and after the intervention the results (per 1000 days) were: VAP incidence, 23.92 vs 16.46 (P = 0.04); cost of antimicrobials, €71,384 vs €63,446 (P = 0.002); and days of mechanical ventilation, 507.5 vs 377.5 (P = 0.009). From the moment of induction of anaesthesia all patients undergoing major heart surgery should routinely receive ASS.
建议对需要机械通气≥48 小时的患者进行声门下分泌物抽吸（ASS）。我们在一项生态学研究中评估了在所有大心脏手术后患者中常规进行 ASS 的影响，该研究比较了 ASS 实施前后呼吸机相关性肺炎（VAP）的发生率、机械通气天数和抗菌药物的成本。在干预前后的结果（每 1000 天）为：VAP 发生率，23.92 比 16.46（P=0.04）；抗菌药物成本，71384 欧元比 63446 欧元（P=0.002）；机械通气天数，507.5 天比 377.5 天（P=0.009）。从诱导麻醉开始，所有接受大心脏手术的患者都应常规接受 ASS。
