Open Suction Circuit Flushing With Chlorhexidine Decreases Ventilator-Associated Pneumonia: A Quasi-experimental Study

NCT05206721 | Completed Early Phase 1 DMC

• 1 other identifier: 245/2020
• Study Type: interventional
• Target: 136
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Standard practice of flushing saline over the patient's secretions following suctioning is similar to pouring water over grease, leading to motivating bacterial colonization and proliferation inside the suctioning circuit (i.e., catheter, tube, and collecting jar), which can then migrate to patient's lung during suctioning procedure causing ventilator-associated pneumonia (VAP). Therefore, flushing this circuit using an appropriate disinfectant to prevent bacterial colonization inside it and thus decreasing pneumonia occurrence has been our crucial investigation idea. Aim: To investigate the effect of suction system flushing with chlorhexidine (CHX) on the occurrence of VAP among mechanically ventilated patients (MVPs). Design: This study adopted a quasi-experimental research design, and a convenience sampling technique was used to recruit 136 patients to conduct this study. Setting: This study was conducted at surgical intensive care units of Mansoura University Emergency Hospital, Egypt. Results: The intervention group patients had a lower incidence of VAP (by 48.12%) compared with the control group. Moreover, the proposed technique was more effective in decreasing the incidence of late-VAP more than early-VAP. Furthermore, CHX reduced the cost of suction system flushing by 75%. Conclusion: Suction system flushing with CHX can significantly reduce the occurrence of VAP among MVPs and reduce the flushing cost. Therefore, this study recommends incorporating CHX into the daily care of MVPs.

Conditions

Ventilator Associated Pneumonia

Keywords

Chlorhexidine; Endotracheal suctioning; Airway managment; suction circuit flushing

Outcome Measures

Primary Outcomes (1)

• VAP Incidence

  Occurrence of Ventilator Associated Pneumonia

  an average of 7 months

Study Arms (2)

Intervention group

EXPERIMENTAL

Other: Open tracheal suction system flushing with chlorhexidine

Control group

NO INTERVENTION

Interventions

Open tracheal suction system flushing with chlorhexidine OTHER

After suctioning the patient's secretions, the responsible nurse inserted the SC into the CHX filled container and flushed the entire suction system with CHX.

Intervention group

Eligibility Criteria

• Age: 14 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• All adult patients admitted to the afore-mentioned ICUs who were intubated within the previous 24 hours and were expected to receive MV support for more than 48 hours were recruited in the study.

You may not qualify if:

• Patients with a clinical diagnosis of pneumonia at the time of admission and/or modified CPIS of 5 or greater.
• Patients who were previously intubated during the current hospital admission.
• Patients who had contraindications to suctioning such as severe hemoptysis, increased intracranial pressure, and cerebrospinal fluid leaks.
• Patients with pulmonary edema, ARDS, and those with atelectasis were also excluded from the study because of their pulmonary infiltrate disease pathophysiology.
• Patients known to be allergic to CHX were also eliminated from the study.

Sponsors & Collaborators

• Mansoura University: lead

Study Sites (1)

Faculty of Nursing

Al Mansurah, Dakahlia Governorate, 35516, Egypt

Location

Related Publications (1)

• Eid MH, Tantu MM, Latour JM, Sultan MA, Kandeel NA. Suction circuit flushing with chlorhexidine decreases ventilator-associated pneumonia: a quasi-experimental study. Front Med (Lausanne). 2023 Dec 4;10:1295277. doi: 10.3389/fmed.2023.1295277. eCollection 2023.

  PMID: 38111699 DERIVED

MeSH Terms

Conditions

Pneumonia, Ventilator-Associated

Interventions

Chlorhexidine

Condition Hierarchy (Ancestors)

Healthcare-Associated Pneumonia; Cross Infection; Infections; Pneumonia; Respiratory Tract Infections; Lung Diseases; Respiratory Tract Diseases; Iatrogenic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Biguanides; Guanidines; Amidines; Organic Chemicals

Study Design

• Study Type: interventional
• Phase: early phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Lecturer

Study Record Dates

• First Submitted: January 11, 2022
• First Posted: January 25, 2022
• Study Start: May 10, 2020
• Primary Completion: June 4, 2020
• Study Completion: November 19, 2020
• Last Updated: January 25, 2022

Record last verified: 2022-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

EG (1)