Increased risks of endotracheal tube cuff colonization after prolonged intubation
Autor: | Hui Chi Hsu, Chung Hung Shih, Wen Hui Tsai |
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Rok vydání: | 2014 |
Předmět: |
Male
medicine.medical_specialty Physiology medicine.medical_treatment Stenotrophomonas maltophilia Serratia Infections Tracheostomy Risk Factors Physiology (medical) Intubation Intratracheal Medicine Infection control Intubation Humans Colonization Serratia marcescens Aged Mechanical ventilation Aged 80 and over Infection Control business.industry Ventilator-associated pneumonia Middle Aged medicine.disease Respiration Artificial Surgery Klebsiella Infections Pneumonia Klebsiella pneumoniae Anesthesia Cuff Sputum Equipment Contamination Female medicine.symptom business Gram-Negative Bacterial Infections |
Zdroj: | The Chinese journal of physiology. 57(3) |
ISSN: | 0304-4920 |
Popis: | Mechanical ventilation using endotracheal tube (ETT) intubation is crucial in saving life but may also cause ventilator-associated pneumonia resulting in morbidity and mortality. The purpose of this study was to examine the effects of intubation duration on pathogen colonization rates of ETT cuff region, and its association with the subsequent re-intubation and tracheostomy. We enrolled 92 patients who were successfully weaned from ventilator and were extubated within 20 days of intubation duration. Patients were divided into Group I and II based on intubation for 1-9 days and 10-20 days, respectively. Pathogen colonization over ETT cuff region and extra-cuff region (including sputum and ETT aspirates) were assessed. As compared to Group I patients, Group II patients had a significant higher pathogen colonization rate (100% vs. 69.2%; P < 0.001) in the ETT cuff samples, but not in the extra-cuff samples (92.6% vs. 84.8%; P = 0.442). Further studies demonstrated that there was no difference between Group I and II patients in the percentages of patients with the same pathogen over both the cuff and extra-cuff samples (35.5% vs. 30.8%; P = 0.925), suggesting that the increased pathogen colonization rate over the ETT cuff region was least likely from the extra-cuff region. In addition, the results showed that longer intubation was also associated with increased tracheostomy rate from 9.3% to 28.9% for Group I and Group II respectively (P = 0.025). We conclude that longer intubation has a higher pathogen colonization rate over the ETT cuff region in patients receiving mechanical ventilation support; longer intubation also increases the trend of receiving re-intubation and tracheostomy. Our findings indicate that it is crucial to remove ETT as soon as possible and perform pathogen culture over the ETT cuff regions immediately after extubation. |
Databáze: | OpenAIRE |
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