The Effects Of Two Different Subglottic Secretion Drainaging Methods For Ventilator-Associated Pneumonia And Tracheal Mucosal Injury In Patients With Mechanical Ventilation:A Meta-Analysis

Objective:To evaluate the effects of continuous subglottic suction and intermittent subglottic suction on the prevention of ventilator-associated pneumonia(VAP)and the damage to airway mucosa.Methods:Randomized controlled trials published in Pub Med,Cochrane library,Web of Science,Science Direct,EMBASE,CNKI,WANFANG,VIP regarding comparison between continuous and intermittent subglottic secretion drainage were searched from inception to March 31 st,2019.Two reviewers independently screened the literature,extracted data,and evaluated the risk of bias in the included studies,then Review Manager 5.3 and Stata 15.1 software were used for meta-analysis.Results:Nine studies enrolling a total of 865 patients were included.The results of meta-analysis showed there were no significant differences in the incidence of VAP[RR=1.06,95%CI(0.88,1.28),P=0.53],incidence of early-onset VAP [RR=1.09,95%CI(0.66,1.79),P=0.74],duration of mechanical ventilation [MD=0.12,95%CI(-0.49,0.72),P=0.70],length of staying in intensive care unit [MD=-0.16,95%CI(-0.88,0.56),P=0.66] and mortality rate [RR=0.92,95%CI(0.69,1.23),P=0.58] between continuous and intermittent subglottic secretion drainage.The incidence of testing for occult blood [RR=2.74,95%CI(1.72,4.37),P<0.0001] of intermittent subglottic secretion drainage was lower than continuous subglottic secretion drainage and the difference was statistically significant.Conclusion:There were no apparent differences between continuous and intermittent subglottic secretion drainage for preventing VAP,but continuous subglottic secretion drainage was easy to damage tracheal mucosa.