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Impact of Subglottic Saline Irrigation on Reducing Bacterial Contamination for Oral Surgery Patients

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Journal Anesth Prog
Date 2020 Jul 8
PMID 32633772
Citations 1
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Abstract

This study investigated the effectiveness of subglottic irrigation (SI) with 100 mL of saline on reducing bacterial contamination in the subglottic space during oral surgery procedures without the use of throat packs. Subglottic lavage and irrigation were performed through the suction lumen located on specialized endotracheal tubes (ETTs) with capabilities of permitting evacuation from the subglottic space. Fifty-three patients who were scheduled for oral surgery procedures under general anesthesia while intubated with specialized ETTs at Kyushu Dental University Hospital were enrolled in this study. Subglottic irrigation was performed, and the sample fluid was collected through the ETT suction lumen for smear and culture bacterial examinations after 3 points in time: immediately after intubation, after completing the surgical procedure, and again after SI. Oral surgery without a throat pack significantly increased bacterial contamination in the subglottic lavage (p < .001), and SI decreased bacterial contamination (p < .001) similarly to levels found after tracheal intubation. Subglottic irrigation with 100 mL of saline was effective in reducing bacterial load in the subglottic space to levels similarly noted immediately after intubation for patients undergoing intraoral surgical procedures without the use of a throat pack.

Citing Articles

Effects of throat packs in upper airway surgery under intubation anesthesia: a randomized controlled trial.

Pabst A, Muller D, Thiem D, Scherhag A, Kruger M, Heimes D Clin Oral Investig. 2022; 26(11):6795-6804.

PMID: 35904640 DOI: 10.1007/s00784-022-04641-4.

References
1.
El-Solh A, Pietrantoni C, Bhat A, Aquilina A, Okada M, Grover V . Microbiology of severe aspiration pneumonia in institutionalized elderly. Am J Respir Crit Care Med. 2003; 167(12):1650-4. DOI: 10.1164/rccm.200212-1543OC. View

2.
Hagler D, Traver G . Endotracheal saline and suction catheters: sources of lower airway contamination. Am J Crit Care. 1994; 3(6):444-7. View

3.
Blot S, Rello J, Koulenti D . The value of polyurethane-cuffed endotracheal tubes to reduce microaspiration and intubation-related pneumonia: a systematic review of laboratory and clinical studies. Crit Care. 2016; 20(1):203. PMC: 4921025. DOI: 10.1186/s13054-016-1380-8. View

4.
Reper P, Dicker D, Damas P, Huyghens L, Haelterman M . Improving the quality of the intensive care follow-up of ventilated patients during a national registration program. Public Health. 2017; 148:159-166. DOI: 10.1016/j.puhe.2017.03.014. View

5.
Magill S, Klompas M, Balk R, Burns S, Deutschman C, Diekema D . Developing a new, national approach to surveillance for ventilator-associated events*. Crit Care Med. 2013; 41(11):2467-75. PMC: 10847970. DOI: 10.1097/CCM.0b013e3182a262db. View