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Meta-Analysis
. 2018 Jul;97(28):e11223.
doi: 10.1097/MD.0000000000011223.

Influence of Subglottic Secretion Drainage on the Microorganisms of Ventilator Associated Pneumonia: A Meta-Analysis for Subglottic Secretion Drainage

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Free PMC article
Meta-Analysis

Influence of Subglottic Secretion Drainage on the Microorganisms of Ventilator Associated Pneumonia: A Meta-Analysis for Subglottic Secretion Drainage

Xu An Huang et al. Medicine (Baltimore). .
Free PMC article

Abstract

Background: The influence of the subglottic secretion drainage (SSD) on the microorganisms of ventilator associated pneumonia (VAP) is still unclear.A meta-analysis focusing on the influence of the SSD on the microorganisms of VAP.

Methods: A comprehensive search was conducted through the online studies of PubMed, Embase, Cochrane Library, Google scholar, CNKI (China National Knowledge Infrastructure), and VIPI (Database for Chinese Technical Periodicals) using specific search terms.Included studies were randomized controlled trials (RCTs) that compare the microorganisms of VAP between SSD and standard endotracheal tube care in mechanically ventilated adults.

Results: Nine RCTs were eligible. There was no significant difference in the rate of VAP caused by nonfermentative bacteria and enterobacteria between SSD group and control group (OR = 0.73, 95%CI, 0.53-1.01; P = .06). The episodes of VAP caused by Gram-positive cocci and Haemophilus influenzae organisms were lower in the SSD group (OR = 0.29, 95%CI, 0.18-0.48; P<0.00001). Less mean volume of SSD daily was observed in VAP group (OR = -16.97, 95%CI, -29.87-4.08; P = .010).

Conclusion: We found SSD to be associated with significant decreases in VAP caused by Gram-positive cocci and H influenzae organisms but no significant differences in VAP caused by nonfermentative bacteria and enterobacteria. Less mean volume of SSD daily was observed in VAP group.

Conflict of interest statement

Conflict of interest: We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

No conflict of interest exits in the submission of this manuscript, and manuscript is approved by all authors for publication.

Figures

Figure 1
Figure 1
The graph shows a flow diagram of details search and exclusion criteria.
Figure 2
Figure 2
The graph shows a risk of bias graph.
Figure 3
Figure 3
The graph shows a risk of bias summary.
Figure 4
Figure 4
The graph shows a forest plot of relative risk with confidence interval for VAP caused by nonfermentative bacteria and enterobacteria. VAP = ventilator associated pneumonia.
Figure 5
Figure 5
The graph shows a forest plot of relative risk with confidence interval for VAP caused by Gram-positive cocci and H influenzae organisms. VAP = ventilator associated pneumonia.
Figure 6
Figure 6
The graph shows a forest plot of relative risk with confidence interval for the mean volume of SSD daily between VAP group and non-VAP group. SSD = subglottic secretion drainage, VAP = ventilator associated pneumonia.

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