Polymixin via ETT

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Hello again!

I've got this posted in all the ICU forums...just wondering how many ICU's out there use inline suction and if you do, do you use polymixinB down the ETT when suctioning as a VAP preventative? I am trying to find out if this is common. We use this on all pts with inlines in my NICU but the PICU/CICU do not and there is no official policy for it. I found some scattered research dated a few years back that some studies showed its usefulness while others couldn't argue either way.

Thanks for the input!

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Specializes in NICU.

We use inline suction 100% of the time. No Polymixin here. Fairly low rates of VAP, although I'm sure we could do better.

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We use inline suction 100% of the time. No Polymixin here. Fairly low rates of VAP, although I'm sure we could do better.

Thanks! we did not use it 100% of the time in the NICU, all HFOV had inlines and then nursing had to beg and plead to get it for kids on nitric (though our policy is always for nitric) and those other kids that either have copious secretions or don't tolerate bagging, (our docs tell us inlines increase vap rates) but we always used polymixin but regardless it seems our long term intubated kiddos still get vap quite a bit so I wasn't sure myself if the polymixin was working

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Specializes in NICU.

Inline suction should reduce your VAP, not increase it.

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Thats what I would think but our docs do not agree...and that thinking spans all the ICU's at my hospital

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Specializes in NICU, PICU, educator.

We have never used that. We use inline suction also. Current EBP shows that you should not use saline down the tube as it washes the colonized stuff down the ETT to the lungs...I wonder if this is the same with the polymixin. We have a VAP bundle in place, most of it came from ihi.org .

We also use separate suction for our tubes and oral, that is another part of the bundle.

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Specializes in Neonatal ICU (Cardiothoracic).

While we usually have very few intubated babies on our unit (most are aggressively placed on NCPAP), we have a very low incidence of VAP. Usually only on our older vent/trach babies. We do not use anything except saline, and occasionally q3-4 ultrasonic saline nebs to loosen secretions.

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