Efficacy of subglottic secretion drainage on prevention of ventilator associated pneumonia: A systematic review

Abstract

Ventilator associated pneumonia (VAP) is one of the most common nosocomial infections with a high mortality rate. Subglottic secretion drainage (SSD) has been studied extensively as a strategy for VAP prevention and is recommended in several guidlines. However, SSD is not widespread, due to the weakness of the quality of evidence. Methods: A comprehensive search was performed through PubMed, Scopus, and Cochrane Library using specific search terms. Included studies were randomized controlled trials, evaluating the effect of subglottic secretion drainage on the incidence of VAP in critically ill patients under mechanical ventilation. Results: Thirteen clinical trials were included in this systematic review. Results showed a low heterogeneity among the studies (I2 = 13%, p = 0.32). The forest plot showed that the incidence of VAP in SSD was significantly lower than Non-SSD (OR=0.53; 95% CI, 0.42–0.67; P<0.001). The Funnel plot results indicate no diffusion bias.