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  • Cited by 3
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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Lachérade, J. -C. 2013. Drainage des sécrétions sous-glottiques et pneumonies acquises sous ventilation mécanique. Réanimation, Vol. 22, Issue. 3, p. 257.

    Weavind, Liza M. Saied, Nahel Hall, J. D. and Pandharipande, Pratik P. 2013. Care Bundles in the Adult ICU: Is It Evidence-Based Medicine?. Current Anesthesiology Reports, Vol. 3, Issue. 2, p. 79.

    Williams, Teresa A. 2012. Is the evidence for the use of subglottic drainage to prevent ventilated-associated pneumonia sufficient to change practice?. Australian Critical Care, Vol. 25, Issue. 3, p. 200.

  • Infection Control & Hospital Epidemiology, Volume 32, Issue 2
  • February 2011, pp. 131-135

Is Continuous Subglottic Suctioning Cost-Effective for the Prevention of Ventilator-Associated Pneumonia?

  • Corinne Hallais (a1), Véronique Merle (a1), Pierre-Gildas Guitard (a2), Anne Moreau (a1), Valérie Josset (a1), Denis Thillard (a1), Suzanne Haghighat (a3), Benoit Veber (a2) and Pierre Czernichow (a1)
  • DOI:
  • Published online: 01 January 2015

To establish whether continuous subglottic suctioning (CSS) could be cost-effective.


Cost-benefit analysis, based on a hypothetical replacement of conventional ventilation (CV) with CSS.


A surgical intensive care unit (SICU) of a tertiary care university hospital in France.


All consecutive patients receiving ventilation in the SICU in 2006.


Efficacy data for CSS were obtained from the literature and applied to the SICU of our hospital. Costs for CV and CSS were provided by the hospital pharmacy; costs for ventilator-associated pneumonia (VAP) were obtained from the literature. The cost per averted VAP episode was calculated, and a sensitivity analysis was performed on VAP incidence and on the number of tubes required for each patient.


At our SICU in 2006, 416 patients received mechanical ventilation for 3,487 ventilation-days, and 32 VAP episodes were observed (7.9 episodes per 100 ventilated patients; incidence density, 9.2 episodes per 10,000 ventilation-days). Based on the hypothesis of a 29% reduction in the risk of VAP with CSS than CV, 9 VAP episodes could have been averted. The additional cost of CSS for 2006 was estimated to be €10,585.34. The cost per averted VAP episode was €1,176.15. Assuming a VAP cost of €4,387, a total of 3 averted VAP episodes would neutralize the additional cost. For a low VAP incidence of 6.6%, the cost per averted VAP would be €1,323. If each patient required 2 tubes during ventilation, the cost would be €1,383.69 per averted VAP episode.


Replacement of CV with CSS was cost-effective even when assuming the most pessimistic scenario of VAP incidence and costs.

Corresponding author
Department of Epidemiology and Public Health, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France (
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26.RC Harvey , P Miller , JA Lee , DL Bowton , DA MacGregor . Potential mucosal injury related to continuous aspiration of subglottic secretion device. Anesthesiology 2007;107:666669.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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