Commentary on Berry et al.: “Effects of three approaches to standardized oral hygiene to reduce bacterial colonization and ventilator associated pneumonia in mechanically ventilated patients: A randomized control trial” [Int. J. Nurs. Stud. 48 (2011) 681–688]

2015 ◽  
Vol 52 (1) ◽  
pp. 502-503
Author(s):  
Jennifer A. Gibson
Keyword(s):  
Oral Hygiene ◽  
Randomized Control Trial ◽  
Bacterial Colonization ◽  
Ventilator Associated Pneumonia ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Randomized Control ◽  
Ventilated Patients

scholarly journals The role of bacterial colonization of ventilator circuit in development of ventilator associated pneumonia in ICU of Medical Center Hospital in Tripoli, Libya

2021 ◽  
Vol 3 (2) ◽  
pp. 109-114
Author(s):  
Asma Elkammoshi ◽  
◽  
Abir Ben Ashur ◽  
Hamida El Magrahi ◽  
Aya Abdulatif ◽  
...  
Keyword(s):  
Medical Center ◽  
Bacterial Colonization ◽  
Ventilator Associated Pneumonia ◽  
Ventilator Circuit ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Paired Samples ◽  
A Prospective Study ◽  
Ventilated Patients

Introduction: In mechanically ventilated patients, ventilator-associated pneumonia (VAP) is a major cause of prolonged hospitalization with increased morbidity and mortality. There is a lack of studies on the relationship between bacterial colonization of the ventilator circuit (VC) and VAP. This study aimed to investigate the role of bacterial colonization of VC in the development of VAP and identify antibiotic susceptibility trends for isolated strains. Methods: A prospective study of the bacterial culture has been performed between February 2021 to March 2021 on a total of 100 mechanically ventilated patients, (n =50) samples have been obtained from patient's lower respiratory tract (LRT) and (n =50) were taken from mechanical ventilator equipment VC. Paired samples of bacteria isolated from VC and LRT, where VC was colonized before LRT. Results: A total of 58 samples were cultured positively, while 42 specimens showed negative bacterial growth. However, there was no substantial difference in comparing between the bacterial colonization of the ventilator system and the patient samples. Most isolated organisms were gram-negative bacteria which were found in the ventilator circuit with 26 (68.4%), and 14 (70%) in patient’s LRT. Gram-positive was detected in 12 (31.6%) and 6 (30%) of the ventilator circuit, and patient's LRT, respectively. The predominant bacterial type was Acinetobacter baumannii organism at the VC with 10 (26.3%) and LRT at 4 (20%) followed by Klebsiella pneumoniae (8 (21.1%) in VC and 4 (20%) in LRT). Moreover, A. baumannii showed a full resistance to amoxicillin and the first generation of cephalosporins, while the other bacterial types were resistant to the most antibiotics used in this research. Conclusions: Bacterial colonization of ventilator circuit VC is a significant cause of VAP development in mechanically ventilated patients. Preventive strategies for the early detection and decontamination of contaminated VC can play a crucial role in ventilator-associated pneumonia prevention.

CUIDADOS BUCAIS EM PACIENTES VENTILADOS MECANICAMENTE: CONHECIMENTO DE ENFERMEIROS DE UM HOSPITAL ESCOLA

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Gérsica Sampaio Silva ◽  
Fernanda Alves Ferreira Gonçalves ◽  
Bárbara Ribeiro Miquelin Bueno ◽  
Georlucya Kátia Da Silva Ferreira ◽  
Ludmila Pinheiro Da Silva ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Oral Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Complicating Factors ◽  
Materials Used ◽  
Ventilated Patients

Objetivo: Avaliar o conhecimento acerca dos cuidados bucais realizados por enfermeiros a pacientes ventilados mecanicamente. Método: Estudo transversal, realizado em um hospital escola de Goiânia/Goiás. A coleta de dados deu-se por meio de questionário estruturado. Resultados: Os enfermeiros conhecem as medidas recomendadas sobre higiene bucal. Os fatores dificultadores encontrados foram a falta de pessoal (21,7%), falta de tempo (16,7%) e trabalhos burocráticos (15%). Contudo ainda existem lacunas no que se refere a produtos e materiais utilizados na higiene bucal. Conclusão: As Lacunas e os fatores dificultadores sinalizados nesse estudo merecem reflexão, como forma de avaliar a qualidade do cuidado oferecido.Descritores: Biofilme; Higiene Bucal; Cuidados de enfermagem.ORAL CARE IN MECHANICALLY VENTILATED PATIENTS: KNOWLEDGE OF NURSES FROM A SCHOOL HOSPITALObjective: To evaluate the knowledge about oral care performed by nurses in mechanically ventilated patients. Methods: a cross-sectional study, conducted in a teaching hospital of Goiania/Goias. The data collection was performed by means of a structured questionnaire. Results: The nurses know the measures recommended on oral hygiene. The complicating factors found were the lack of personnel (21.7%), lack of time (16.7%) and work on tape (15%). However there are still gaps in relation to products and materials used in oral hygiene. Conclusion: The gaps and the factors complicating factors indicated in this study deserve consideration, as a means of evaluating the quality of care offered.Keywords: Biofilm; Oral hygiene; Nursing care.CUIDADO ORAL EN PACIENTES CON VENTILACIÓN MECÁNICA: EL CONOCIMIENTO DE LAS ENFERMERAS DEL HOSPITAL ESCUELAObjetivo: Evaluar el conocimiento sobre el cuidado bucal realizadas por enfermeras en pacientes ventilados mecánicamente. Métodos: Estudio transversal, realizado en un hospital de Goiania y Goias. La recolección de datos se realizó por medio de un cuestionario estructurado. Resultados: Las enfermeras saben las medidas recomendadas en la higiene bucal. Los factores encontrados fueron la falta de personal (21,7%), la falta de tiempo (16,7%) y trabajar en la cinta (15%). Sin embargo todavía hay lagunas en relación con los productos y los materiales utilizados en la higiene bucal. Conclusión: Las brechas y los factores factores indicados en este estudio merecen consideración, como medio de evaluar la calidad de la atención ofrecida.Palabras clave: Biofilme; Higiene Bucal; Atención de Enfermería.

Probiotics for Disease Prevention: A Focus on Ventilator-Associated Pneumonia

2011 ◽  
Vol 45 (11) ◽  
pp. 1425-1432 ◽  
Author(s):  
Jennifer L Bailey ◽  
Siu Yan Yeung
Keyword(s):  
Antimicrobial Agents ◽  
Future Research ◽  
Published Data ◽  
Ventilator Associated Pneumonia ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Patient Disposition ◽  
Significant Difference ◽  
Colonization Rates ◽  
Ventilated Patients

Objective: To summarize published data regarding the safety and efficacy of probiotics in the prevention of ventilator-associated pneumonia (VAP). Data Sources: PubMed databases (January 2000-August 2011) were searched and a bibliographic review of published articles was performed to identify original reports of probiotic administration for the prevention of VAP using the search terms probiotics, synbiotics, and ventilator-associated pneumonia. Study Selection and Data Extraction: Two pilot studies, 2 randomized controlled trials (RCTs), and 1 meta-analysis have addressed probiotic use for VAP prevention and were included in the review. Data Synthesis: VAP frequently occurs in mechanically ventilated patients. Given the lack of new antimicrobial agents, probiotics have been studied for their ability to modify human microflora colonization. Two studies examining pathogen colonization rates favored probiotics, with reduced incidence and increased duration until the emergence of new species. One prospective RCT found significant reduction in the incidence of VAP and colonization rates, but no significant difference in patient disposition outcomes. Another RCT examining 28-day mortality found no overall benefit with probiotic use and no reduction in colonization rates. Conclusions: Clinical trials have failed to demonstrate a consistent beneficial effect of probiotics in mechanically ventilated patients; thus, they are not recommended for routine clinical use. However, heterogeneity among study designs may hinder this assessment and the designs should be unified in future research.

scholarly journals Effect of gastric residual volume monitoring on incidence of ventilator-associated pneumonia in mechanically ventilated patients admitted to intensive care unit

2019 ◽  
Vol 36 (1) ◽  
Author(s):  
Elnaz Faramarzi ◽  
Ata Mahmoodpoor ◽  
Hadi Hamishehkar ◽  
Kamran Shadvar ◽  
Afshin Iranpour ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Ventilator Associated Pneumonia ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Icu Length Of Stay ◽  
Ventilated Patients

Objectives: The value of gastric residual volume (GRV) monitoring in ventilator-associated pneumonia (VAP) has frequently been questioned in the past years. In this trial, the effect of GRV on the frequency of VAP was evaluated in critically ill patients under mechanical ventilation. Methods: This descriptive study was carried out on 150 adult patients admitted to the intensive care unit over a 14-month period, from October 2015 to January 2017. GRV was measured every three hours, and gastric intolerance was defined as GRV>250 cc. The incidence of vomiting and VAP, GRV, length of mechanical ventilation and ICU stay, APACHE II and SOFA scores, and mortality rate were noted. Results: The mean APACHEII and SOFA scores, ICU length of stay, and duration of mechanical ventilation in the GRV>250ml group were significantly higher than in the GRV≤250 ml group (P<0.05). Also, a significantly higher number of patients in the GRV>250ml group experienced infection (62.3%) and vomiting (71.7%) compared with the GRV≤250 group (P<0.01). The highest OR was observed for SOFA score >15 and APACHE II >30, which increased the risk of GVR>250 ml by 10.09 (1.01-99.97) and 8.78 (1.49-51.58), respectively. Moreover, the increase in GVR was found to be higher in the non-survivor than in the survivor group. Conclusion: Increased GRV did not result in increased rates of VAP, ICU length of stay, and mortality. Therefore, the routine measurement of GRV as an important element of the VAP prevention bundle is not recommended in critically ill patients. How to cite this: Faramarzi E, Mahmoodpoor A, Hamishehkar H, Shadvar K, Iranpour A, Sabzevari T, et al. Effect of gastric residual volume monitoring on incidence of ventilator-associated pneumonia in mechanically ventilated patients admitted to intensive care unit. Pak J Med Sci. 2020;36(1):---------. doi: https://doi.org/10.12669/pjms.36.1.1321 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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