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Continuous subglottic suction is effective for prevention of ventilator associated pneumonia

Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle upon-Tyne NE7 7DN, UK

*Corresponding author. Tel/fax: +44 7801548122.

E-mail address: joeldunning{at}doctors.org.uk (J. Dunning).

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether subglottic suction is an effective preventative measure for ventilator associated pneumonia (VAP) after cardiac surgery. Altogether 457 papers were found using the reported search, of which 13 presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude Subglottic suction significantly reduces the incidence of VAP in high risk patients (NNT of 8 if ventilated over 3 days), although the benefit is lower in elective cardiac patients. Subglottic suction is currently not commonly used, but even with marginal benefits, its use is likely to be highly cost effective.

Key Words: Evidence-based medicine; Subglottic suction; Ventilator-associated pneumonia; Review