Does subglottic secretion drainage prevent ventilator-associated pneumonia?

AIM: To compare the incidence of ventilator-associated pneumonia (VAP) in patients who were admitted to the intensive care unit (ICU) for reasons other than pneumonia and followed up under mechanical ventilation either with standard endotracheal tubes or endotracheal tubes with subglottic secretion drainage (SSD). MATERIALS AND METHODS: Patients who were admitted to the ICU between April 2012 and January 2013 were prospectively and sequentially randomized to standard endotracheal and SSD intubation groups. Patients with pulmonary infection at ICU admission were excluded. Pulmonary imaging, blood, and sputum cultures were routinely screened, and pleural fluid and bronchial lavage examinations were done on demand. RESULTS: Mean age, gender distribution, APACHE II scores, duration of mechanical ventilation, and follow-up of patients with standard (n = 30) and SSD (n = 12) intubation tubes were similar; 71 ± 10.4 versus 64.4 ± 13.9 years (P > 0.05), male/female 18/12 versus 9/3 (P > 0.05), APACHE II scores 20.2 ± 3.8 versus 17.0 ± 3.8 (P = 0.02), 15.9 ± 11.5 versus 11.0 ± 8.1 days (P > 0.05), and 18.0 ± 12.4 versus 15.5 ± 12.2 days (P > 0.05), respectively. The incidence of VAP was similar in both groups (36.7% vs. 33.3%, P > 0.05, in standard vs. SSD groups, respectively). The mortality rate was higher in the standard intubation group, but the difference was not statistically significant (70% vs. 41%, P > 0.05). CONCLUSION: Compared to standard endotracheal intubation, intubation with SSD tubes was not associated with an improvement in the duration of mechanical ventilation, length of stay in the ICU, incidence of VAP, and mortality rate. Due to the limited number of patients included in this study, the results have to be confirmed in larger studies on more patients

The comparative value of pleural fluid adenosine deaminase and neopterin levels in diagnostic utility of pleural tuberculosis

Introduction: The aim of the present study was to evaluate and compare the diagnostic accuracy of pleura levels of adenosinedeaminase (ADA) and neopterin for the differential diagnosis of pleural tuberculosis (TP)

Value of Mean Platelet Volume for Disease Activity in Patients with Pulmonary Sarcoidosis

Objective: We aimed to investigate the importance of mean platelet volume (MPV) as a marker for the activation and severity of disease in patients with pulmonary sarcoidosis

COPD: an underdiagnosed disease at hospital environment

Background and Aim Chronic obstructive pulmonary disease (COPD) is a serious disease with morbidity and mortality due to delayed diagnosis until significant symptoms arise. We aimed to assess the utility of spirometry and COPD Assessment Test (CAT) in detecting undiagnosed COPD patients in a localized area

Effects of body position on sleep architecture and quality in subsyndromal adults without apparent obstructive sleep apnea

There is a well-known relationship between sleep quality and body position during sleep in patients with obstructive sleep apnea (OSA). In this study, we aimed to investigate the effects of body position on sleep architecture and sleep quality in subjects without sleep apnea. One hundred and one subjects between 24 and 77 years of age, who had undergone polysomnography and had a respiratory disturbance index (RDI) below 5 were included in the study. Sleep stages and sleep parameters in the right, left, supine and prone positions were examined. Mean sleep duration in S2, S3 and rapid eye movement (REM) were 110, 39 and 20.7min in supine position and 61, 28 and 17min in right position, respectively. Mean RDI at supine position was higher than other positions. Mean minimal oxygen saturation at supine position was significantly lower than other positions. Maximal heart rate and mean arousal index were significantly higher in the supine position. Duration of sleep was highest in the right position in those older than 60 years. Subjects with 40-60 years age had higher duration of sleep in right and supine positions. Female subjects slept more in supine position whereas male ones slept more in right position. Stages of sleep may change according to position. Deteriorations in the parameters of sleep quality (RDI, lowest saturation, arousal index, heart rate) occur in individuals with RDI < 5 as well as in patients with OSA in the supine position

The frequency and properties of REM related obstructive sleep apnea among the patients with mild related obstructive sleep apnea

Introduction: The question if REM related obstructive sleep apnea (OSA) is a specific clinical entity or if it is an early sign of severe sleep disordered breathing as there is high occurrence of REM OSA in mild and moderate cases, recently have attracted the investigators. In this study, we aimed to see the frequency of REM related OSA among patients with mild OSA; and also to evaluate relation between apnea and daytime sleepiness among REM related OSA patients