4.1.2.4. Impact on pulmonary infection. One study reviewed the impact of
NSI before endotracheal suctioning on the development of VAP and
atelectasis [21]. That study determined that the microbiologically
confirmed VAP rate was 10.8% in the group in which 8 mL of normal
saline was instilled. The VAP rate was 23.5% in the group without saline,
representing a significant difference (P b .05). In addition, no difference
in the atelectasis rate was observed between groups, although this rate
was higher in the group without saline [21]