Pulmonary Microbiome of Patients Receiving Mechanical Ventilation: Changes Over Time.
Mary Lou Sole, Shibu Yooseph, Steven Talbert and 6 others
PMID 33644803WHAT IT FOUND
In 16 ventilated patients, tracheal bacterial diversity fell over time.
The decrease was significant in controls but not in the oral-suctioning group. This pilot cannot show suctioning works; it only suggests airway microbiome changes during ventilation.
Key findings
01Tracheal bacterial diversity decreased significantly over time.
02The significant decrease was seen in the control group, while the intervention group did not show a significant decrease in oral or tracheal diversity.
03Mean oral-to-tracheal β-diversity distance differed significantly between intervention and control groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 16 participants were analyzed, 7 in the intervention group and 9 in the control group, so the study is a small pilot. This was a descriptive subanalysis of a parent randomized trial, not a full trial of microbiome outcomes. The analysis measured microbiome diversity, not aspiration or ventilator-associated conditions. Participants were receiving mechanical ventilation, and antibiotic use was reported (2 patients received no antibiotics, and 4 patients received antibiotics every day), so microbiome changes cannot be attributed to suctioning alone.
Declared interests
No conflicts-of-interest statement is provided in the supplied text. The article is tagged as receiving NIH extramural research support.
The easy way to misread this
Do not conclude that oral suctioning protects the pulmonary microbiome or prevents ventilator-associated conditions. This was a pilot subanalysis of 16 patients, and the intervention group did not show a significant decrease in tracheal diversity (P = .07), so the result does not establish an effect.