MECHANICAL VENTILATION WITH OR WITHOUT DAILY CHANGES OF IN-LINE SUCTION CATHETERS

The purpose of this study was to determine the safety and cost-effecti veness of not routinely changing in-line suction catheters for patient s requiring mechanical ventilation. Patients were randomly assigned to receive either no routine in-line suction catheter changes (n = 258) or in-line suction catheter changes every 24 h (n = 263). The main out come measure was the incidence of ventilator-associated pneumonia. Oth er outcomes evaluated included hospital mortality, acquired organ syst em derangements, duration of mechanical ventilation, lengths of intens ive care and hospital stay, and the cost for in-line suction catheters . Ventilator-associated pneumonia was seen in 38 patients (14.7%) rece iving no routine in-line suction catheter changes and in 39 patients ( 14.8%) receiving inline suction catheter changes every 24 h (relative risk, 0.99; 95% CI, 0.66 to 1.50). No statistically significant differ ences for hospital mortality, lengths of stay, the number of acquired organ system derangements, death in patients with ventilator-associate d pneumonia, or mortality directly attributed to ventilator-associated pneumonia were found between the two treatment groups. Patients recei ving in-line suction catheter changes every 24 h had 1,224 catheter ch anges costing a total of $11,016; patients receiving no routine in-lin e suction catheter changes had a total of 93 catheter changes costing $837. Our findings suggest that the elimination of routine in-line suc tion catheter changes is safe and can reduce the costs associated with providing mechanical ventilation.