950: VAP IN IMMUNOCOMPROMISED PATIENTS: A COMPARATIVE STUDY WITH A POSSIBLE NEW SOLUTION

Introduction: Immunocompromised patients with respiratory failure may need mechanical ventilation. They are in higher risk to develop VAP. Routine care of endotracheal tube (ETT) is provided as standard of care in ICU to avoid VAP and other associated complications. Endotracheal intubation with the AnapnoGuard™ (AG) 100s System aims to continuously automatically monitor and adjust cuff pressure and suction subglottic secretions to prevent VAP and tracheal complications. We compared the outcomes in immunocompromised patients intubated with AG system against a matching control group managed with standard ETT and routine care. Methods: Retrospective, comparative, nested study, non-randomized, in patients intubated with the AG 100s System versus routine EET and care, admitted to the ICU at MCF (Abril 2019-June 2022). Patient demographics, diagnosis, duration of intubation, incidence of VAP and airway injury were collected. RedCap was used. Primary end point were VAP and tracheal injury incidence. Secondary outcomes were ICU and Hospital discharge. p< 0.05 was considered significative. Results: 40 MICU patients were included: 21 managed with AG / 19 with standard of care. Demographics in AG group: Age: 60±14 years (Min 24/Max 79). Males 13 (62%), Female 8 (38%). Race: 13 (62%) caucasian, 4 (19%) african-american, 4 (19%) asian. Cause of immunosuppression: Solid Transplant 5 (24%), Non-solid Transplant 9 (43%), Chemotherapy 7 (33%). Reason for intubation: Airway protection 5 (24%), Respiratory Failure 11 (52%, Pneumonia 5 (24%). There was not significant difference in demographics (all p>0.05). Length of intubation was: 64 + 57 hours (Min 3/Max 205). VAP rate was 9.7 per 1000 vent days in the AG group compared with 24.6 per 1000 vent days in the standard of care group. No tracheal injury was reported. For the AG group the ICU discharge was 12 (57%) and Hospital discharge was 9 (43%). ICU and Hospital Discharge outcomes were not statistically different between groups (all p>0.05). Conclusions: The AG 100s System is an effective tool to manage the airway in mechanically ventilated patients and a potential effective device at reducing VAPs in immunocompromised patients.