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    Significant reduction in ventilator-associated pneumonia with the Venner-PneuX System in high-risk patients undergoing cardiac surgery: the Low Ventilator-Associated-Pneumonia study

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    Authors
    Gopal, Shameer
    Luckraz, Heyman
    Giri, Ramesh
    Nevill, Alan M.
    Muhammed, Israr
    Reid, Matthew
    Bickerton, Shelagh
    Jenkins, Donna
    Issue Date
    2014-12-26
    
    Metadata
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    Abstract
    This study assessed whether the Venner-PneuX endotracheal tube (ET) system, which has sub-glottic suction as well as irrigation ports and continuous cuff-pressure monitoring, is associated with a reduction in ventilator-associated pneumonia (VAP) when compared with the standard ET in high-risk patients undergoing cardiac surgery. METHODS: This was a single-institution, prospective, randomized control trial. Patients were categorized as either Group A (Venner-PneuX ET tube, n = 120) or Group B (Standard ET tube, n = 120). Inclusion criteria included patients over the age of 70 years and/or impaired left ventricular function (LVEF <50%) undergoing cardiac surgery. Patients were monitored for VAP for up to 48 h post extubation and the diagnosis of VAP was according to the centres for disease control definition. RESULTS: There were no significant differences in the patients' demographics. The mean (SD) ages for the two groups were 72.4 (8.2) and 72.1 (7.4) years (P = 0.6), respectively. The mean EuroSCORE was 6.39 (2.2) for Group A and 6.48 (2.6) for Group B (P = 0.9). The median intubation times were 14.7 (7.3, 2927.2) h and 13 (2.5, 528.7) h, respectively. VAP incidence was significantly lower in the Venner-PneuX ET group, being 10.8% when compared with 21% in the standard ET group (P = 0.03). There was no significant difference between the two groups in terms of intensive care unit stay (P = 0.2) and in-hospital mortality (P = 0.2). A binary logistic regression analysis (type of ET tube, age, LVEF, history of lung disease, smoking history, surgical procedure, EuroSCORE, cardiopulmonary bypass time, blood transfusion, intubation duration among others) confirmed that the Venner-PneuX ET tube was associated with significant VAP reduction (Odds ratio 0.45, P = 0.03). CONCLUSIONS: The Venner-PneuX VAP prevention system is associated with a significant reduction in VAP. This can potentially lead to significant cost reductions and should be implemented as part of the VAP reduction bundle.
    Citation
    Gopal S., Luckraz H., Giri R., Nevill A., Muhammed I., Reid M., Bickerton S., Jenkins D. (2014) 'Significant reduction in ventilator-associated pneumonia with the Venner-PneuX System in high-risk patients undergoing cardiac surgery: the Low Ventilator-Associated-Pneumonia study' European Journal of Cardio-Thoracic Surgery, 47 (3) e92-6. doi: 10.1093/ejcts/ezu483
    Publisher
    Oxford University Press
    Journal
    European Journal of Cardio-Thoracic Surgery
    URI
    http://hdl.handle.net/2436/337946
    DOI
    10.1093/ejcts/ezu483
    PubMed ID
    25542910
    Type
    Journal article
    Language
    en
    ISSN
    1873-734X
    ae974a485f413a2113503eed53cd6c53
    10.1093/ejcts/ezu483
    Scopus Count
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