Study on the application value of “micro-aspiration” in prevention and control of ventilator-related pneumonia in severely ill patients: A randomized controlled trial

Background: Micro-aspiration is a significant risk factor for ventilator-associated pneumonia (VAP) in critically ill patients. Recent guidelines have increasingly recommended micro-aspiration prevention strategies; however, the practical application and guidance value of these recommendations still require further evaluation. This study aims to analyze the application value of the “micro-aspiration prevention” concept in the prevention and control of VAP in critically ill patients. Methods: We conducted a randomized controlled trial involving 94 critically ill patients at our hospital from April 2021 to May 2023, all of whom received mechanical ventilation. The conventional group followed the standard prevention and control protocol, while the prevention group implemented additional intervention measures guided by the “micro-aspiration prevention” concept in addition to the standard protocol. Results: The prevention group had significantly lower rates of VAP incidence (2.13% vs 14.89%, P < 0.05), micro-aspiration (0% vs 17.02%, P = 0.017), reflux (2.13% vs not specified, P = 0.004), and tracheal mucosal injury (0% vs not specified, P = 0.017) compared to the conventional group. The prevention group also showed lower micro-aspiration risk scores (P = 0.006) and a shorter intensive care unit length of stay (P = 0.036). Conclusion: Our results demonstrate that applying the “micro-aspiration prevention” concept significantly reduces the risk of micro-aspiration and ventilator-associated pneumonia (VAP) in critically ill patients. This approach not only lowers the incidence of VAP and micro-aspiration but also dramatically reduces hospitalization costs and the risk of complications.