GKD Anest Yoð Bak Dern Derg. 2023; 29(2): 68-73 | DOI: 10.14744/GKDAD.2023.03360

Use of Endotracheal Tubes with Subglottic Drainage Reduces Ventilator-associated Pneumonia in Chronic Obstructive Pulmonary Disease Patients After Coronary Surgery

Ýpek Yakýn Düzyol¹, Nurgül Yurtseven², Çaðrý Düzyol³, Abbas Köse^4
1Department of Anesthesiology and Reanimation, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Türkiye
²Department of Anesthesiology and Reanimation, University of Health Sciences, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Ýstanbul, Türkiye
³Department of Cardiac Surgery, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Türkiye
⁴Department of Reanimation, Ministry of Health Kepez State Hospital, Antalya, Türkiye

Objectives: We investigated the effects of endotracheal tubes with subglottic drainage (SGAETT) on the incidence of ventilator-associated pneumonia (VAP) in patients with chronic obstructive pulmonary disease (COPD) undergoing coronary artery bypass grafting (CABG).
Methods: The patients were assigned to one of two groups. Group 1 patients used a SGAETT (n=94); Group 2 controls received standard endotracheal tubes (n=100). The demographic data, number of coronary bypasses performed, and cross clamp (CC) and cardiopulmonary bypass (CPB) durations were recorded. Endotracheal aspiration samples were obtained from patients with suspected VAP in the intensive care unit (ICU). Intubation time, length of ICU and hospital stays, erythrocyte transfusion volume, enteral nutrition needs, transportation needs, and reintubation and sedation needs were recorded.
Results: The VAP rate was 6.8% in Group 1 and 19% in Group 2 (p<0.05). Group 1 patients had lower body weight, smoking, and transportation needs; Group 1 patients also had shorter ICU and hospital stays but demonstrated a greater average body surface area, higher mean pulmonary arterial pressure, more-frequent peptic ulcers, higher mean pulmonary arterial pressure, and Group 1 patients were more likely to have ejection fractions (EFs) less than 40% (p<0.05). A logistic regression analyses found SGAETT independently reduced VAP independently (OR: 0.037) (p<0.05).
Conclusion: SGAETT reduces the incidence of VAP in patients with COPD undergoing cardiac surgery.

Keywords: Chronic obstructive pulmonary disease, coronary artery bypasses grafting, subglottic aspiration, ventilator-associated pneumonia

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