The efficacy of subglottic secretion drainage in preventing ventilator-associated pneumonia in the intensive care unit: a systematic review and meta-analysis
Abstract
Objective To review and analyse the clinical nursing effect of subglottic secretion drainage (SSD) on patients with intensive care unit (ICU) ventilator-associated pneumonia (VAP) through a systematic review and meta-analysis. Methods The clinical articles published between January, 2000 and May, 2024 were screened from PubMed, Web of Science, Spring, and Science Direct databases. After that, the quality of selected articles was assessed and relevant data were extracted. Results According to different adjuvant mechanical ventilation (MV) methods of ventilator, the included patients were enrolled into SSD and control groups. The patients in the former group were treated with SSD, while those in the latter group received routine treatment. RevMan5.3 was employed for the meta-analysis of relevant data. Next, the incidence of VAP, MV duration, length of stay in ICU and hospital, fatality, tracheostomy, incidence of VAP/1,000 ventilator days, and the detection rates for Gram positive and negative bacteria among patients in the two groups were compared. According to the outcomes, 14 qualified articles were included. In contrast to those in control group, the incidence of VAP (OR = 0.42, 95% CI: 0.29 ~ 0.61; Z = 4.52, p < 0.00001), VAP/1,000 ventilator days (OR = 0.44, 95% CI: 0.29 ~ 0.66; Z = 3.91, p < 0.0001), and the detection rates for Gram positive and negative bacteria (OR = 0.41, 95% CI: 0.25 ~ 0.68; Z = 3.44, p = 0.0006; OR = 0.64, 95% CI: 0.46 ~ 0.90; Z = 2.57, p = 0.01)…
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