{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:47:28Z","timestamp":1791251248570,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2010,10,1]],"date-time":"2010-10-01T00:00:00Z","timestamp":1285891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Ventilator-associated pneumonia (VAP) causes substantial morbidity and mortality. The influence of subglottic secretion drainage (SSD) in preventing VAP remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether SSD reduces the overall incidence of microbiologically confirmed VAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomized controlled clinical trial conducted at four French centers. A total of 333 adult patients intubated with a tracheal tube allowing drainage of subglottic secretions and expected to require mechanical ventilation for \u226548 hours was included. Patients were randomly assigned to undergo intermittent SSD (n = 169) or not (n = 164).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Primary outcome was the overall incidence of VAP based on quantitative culture of distal pulmonary samplings performed after each clinical suspicion. Other outcomes included incidence of early- and late-onset VAP, duration of mechanical ventilation, and hospital mortality. Microbiologically confirmed VAP occurred in 67 patients, 25 of 169 (14.8%) in the SSD group and 42 of 164 (25.6%) in the control group (P = 0.02), yielding a relative risk reduction of 42.2% (95% confidential interval, 10.4\u201363.1%). Using the Day 5 threshold, the beneficial effect of SSD in reducing VAP was observed in both early-onset VAP (2 of 169 [1.2%] patients undergoing SSD vs. 10 of 164 [6.1%] control patients; P = 0.02) and late-onset VAP (23 of 126 [18.6%] patients undergoing SSD vs. 32 of 97 [33.0%] control patients; P = 0.01). VAP was clinically suspected at least once in 51 of 169 (30.2%) patients undergoing SSD and 60 of 164 (36.6%) control patients (P = 0.25). No significant between-group differences were observed in duration of mechanical ventilation and hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subglottic secretion drainage during mechanical ventilation results in a significant reduction in VAP, including late-onset VAP.<\/jats:p>\n                    <jats:p>Clinical trial registered with www.clinicaltrials.gov (NCT00219661).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.200906-0838oc","type":"journal-article","created":{"date-parts":[[2010,6,3]],"date-time":"2010-06-03T23:01:26Z","timestamp":1275606086000},"page":"910-917","source":"Crossref","is-referenced-by-count":159,"title":["Intermittent Subglottic Secretion Drainage and Ventilator-associated Pneumonia: A Multicenter Trial"],"prefix":"10.1093","volume":"182","author":[{"given":"Jean-Claude","family":"Lacherade","sequence":"first","affiliation":[{"name":"Medicosurgical Intensive Care Unit, Poissy Saint-Germain Hospital, Poissy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"De Jonghe","sequence":"additional","affiliation":[{"name":"Medicosurgical Intensive Care Unit, Poissy Saint-Germain Hospital, Poissy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Guezennec","sequence":"additional","affiliation":[{"name":"Medicosurgical Intensive Care Unit, Andr\u00e9 Mignot Hospital, Le Chesnay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Debbat","sequence":"additional","affiliation":[{"name":"Medicosurgical Intensive Care Unit, Hospital of Avignon, Avignon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hayon","sequence":"additional","affiliation":[{"name":"Medicosurgical 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