Introduction: Individual disposable airway suction catheters have been frequently replaced by a closed system sheath surrounded catheter not changed after each use. We evaluated whether changing the closed system catheter q 3 days and PRN. instead of q I day and PRN. would maintain the current incidence of nosocomial pneumonias in mechanically ventilated patients. Methods: The study lasted 8 months in a 20 bed Trauma ICU: 4 months for closed catheter systems changed q 1 day, followed by 4 months changing q3 days, with an option of changing the suction system PRN due to malfunction or extreme contamination. Heated-wire mechanical ventilator tubing circuits and closed-system water humidifiers were changed q7 days. Criteria for pneumonia included x-ray finding (new or progressive infiltrate, cavitaoon, consolidation, or pleural effusion) and sputum culture and/or blood culture, as proposed by the Centers for Disease Control and Prevention. Nosocomial pneumonia was defined as meeting these criterion after 3 days. Pneumonia rate was calculated as [pneumonia rate = (pneumonia (n) x 1,000) / total ventilator days]. No attempts were made to alter existing clinical practice, or modify certain procedures, such as "breaking' the circuit to manually Tag' and suction die ventilated patient The assumption was that the incidence of these occurances remained the same. Results: vent davs ft patients nosocomial pneumonia rate ql change 1040 180 16 q3 change 1179 229 10.3 Total patients, ventilator days and average ventilator days per month (5.2 vs 5.7) were similar. There was no difference in pneumonia rates (ANOVA, p=ns) between the ql day and die q3 day and PRN catheter change procedures. Cost savings during the q3 day study period were a shade under S6.700.00 for 4 months, or annualLzed savings of over 520,000.00. Coacliukm: Changing closed-system suction devices qJ days and PRN seems safe and effective. The incidence of nosocomial pneumonia in mechanically ventilated patients is comparable to more frequent changes. Unnecessary disposable equipment costs can be avoided.
|Original language||English (US)|
|Journal||Critical Care Medicine|
|Issue number||1 SUPPL.|
|State||Published - 1998|
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine