scholarly journals Application of Modified Ventilator Bundle and Its Effect on Weaning and Ventilation Days among Critical Ill Patients

2021 ◽  
Vol 2 (4) ◽  
pp. 9
Author(s):  
Amany S. Eweas ◽  
Sahar Y. Mohammad ◽  
Jehan S. A. Sayyed ◽  
Marwa M. Abd Elbaky ◽  
Magda M. Bayoumi
Keyword(s):  
Statistical Significance ◽  
University Hospital ◽  
Hospital Length Of Stay ◽  
Control Group ◽  
Study Group ◽  
Ventilator Associated Pneumonia ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilation Support ◽  
Ventilated Patients

Context: Modified ventilator bundle is the group of interventions supported by evidence to prevent ventilator-associated pneumonia and other related complications that commonly occurred in mechanically ventilated patients. Furthermore, it helps in reducing the mortality rates and hospital length of stay. Aim:  The current study aimed to apply a modified ventilator bundle and evaluate its effect on weaning and ventilation days among critically ill patients. Methods: A quasi-experimental research (study/control group) design was utilized. This study was conducted at the following critical care units (surgical, medical, and cardiac care units) affiliated to Bani Suief University Hospital in Bani Suief city, Egypt. A Purposive sample of 100 mechanically ventilated patients was divided into two groups. The study group included patients who received a modified ventilator bundle, while the control group included patients who received routine hospital nursing care. Data collection tools included two tools. The first tool is a patient assessment record, and the second tool is the weaning process assessment checklists using burns wean assessment program score. Results: 68.0% of the study group, compared with only (40.0%) of the control group, had a shorter duration of mechanical ventilation support between (4- 6) days with mean ± SD of 6.1 ± 1.6 and 7.3 ± 1.9, respectively after modified bundle implementation with statistical significance differences (p-value 0.005). The study group of patients obtained higher weaning scores than the control group according to burns weaning scores.   Conclusion: The study group demonstrated higher weaning scores and shorter ventilation support duration than the control group. Developing a simplified and comprehensive training associated with demonstrative booklet, including information about ventilator-associated pneumonia, components of modified ventilator bundle, and its importance for ventilated patients to improve nurses' knowledge and practice. Furthermore, replicating the current study on a larger probability sample from different geographical locations to generalize results.

Daily Interruption of Sedation with Physical and Occupational Therapy in Mechanically Ventilated Patients

2018 ◽  
pp. 309-316
Author(s):  
Michael Wolfe ◽  
Daniel Saddawi-Konefka
Keyword(s):  
Occupational Therapy ◽  
Functional Status ◽  
Intervention Group ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Control Group ◽  
Icu Patients ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Schweickert et al. studied effects of early physical and occupational therapy in mechanically ventilated patients. 109 mechanically ventilated medical ICU patients (with independent functional status prior to hospitalization) were randomized to receive physical and occupational therapy initiated at time of enrollment (intervention group) vs. physical and occupational therapy ordered at the discretion of the primary team (control group), with both groups receiving daily interruptions of sedation. The primary outcome, independent functional status at time of discharge, was met in 59% of the intervention group vs. 35% of the control group (p = 0.02). Lower rates of ICU and hospital delirium were observed in the intervention group. Hospital length of stay and mortality were unaffected. This study demonstrated that physical and occupational therapy can be safely accomplished in critically ill, mechanically ventilated medical ICU patients, and that early implementation of therapy may improve return to independent functional status at hospital discharge.

scholarly journals THE EFFECT OF GASTRIC GAS EMPTYING ON THE RESIDUAL GASTRIC VOLUME IN MECHANICALLY-VENTILATED INTENSIVE CARE UNIT PATIENTS FED THROUGH NASOGASTRIC TUBES: A RANDOMIZED, SINGLE-BLIND, CLINICAL TRIAL

2018 ◽  
Vol 11 (9) ◽  
pp. 492
Author(s):  
Ali Mohammadpour ◽  
Mousa Sajadi ◽  
Somayyeh Maghami ◽  
Hossein Soltani
Keyword(s):  
Clinical Trial ◽  
Gastric Volume ◽  
Control Group ◽  
Case Group ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Residual Gastric Volume ◽  
Nasogastric Tubes ◽  
Single Blind ◽  
Ventilated Patients

Objective: Increased gastric residual volume is a complication of enteral nutrition intolerance that leads to gastrointestinal complications such as nausea, vomiting, and aspiration pneumonia. The present study was conducted to determine the effect of gastric gas emptying on the residual gastric volume in mechanically-ventilated patients fed through nasogastric tubes.Methods: This randomized, single-blind, clinical trial was conducted on two groups of patients in the intensive care unit (ICU) of Kamyab Hospital of Mashhad. A total of 64 patients were randomly divided into a case and a control group. In the case group, the gastric gases accumulated through the nasogastric tube were emptied by applying palm pressure on the epigastric region. The control group did not undergo this intervention but received the routine care provided in the ward. Data were collected using a demographic questionnaire and a form containing records of the patients’ residual gastric volume and disease-related information. The residual gastric volume was measured and compared in the two groups before and after the intervention. Data were analyzed in SPSS-19 using the Chi-square test, the independent t-test, and the repeated measures ANOVA at the significance level of 5%.Results: The residual gastric volume did not differ significantly between the two groups before the intervention (p=0.14); after the intervention; however, a significant reduction was observed in the case group compared to the controls (p=0.007).Conclusion: Gastric gas emptying helps reduce the residual gastric volume in mechanically-ventilated patients fed through nasogastric tubes. Further studies are recommended to further ensure the benefits of this method.

scholarly journals Effectiveness of Communication Board on Level of Satisfaction Over Communication among Mechanically Venitlated Patients

2020 ◽  
Vol 5 (9) ◽  
pp. 311-316
Author(s):  
Dr. Metilda ◽  
Dr. A. Jaganath
Keyword(s):  
Mechanical Ventilation ◽  
Control Group ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
Group 15 ◽  
Experimental Group ◽  
Ventilated Patients ◽  
Communication Board

Mechanical ventilation is widely used to treat patients with critical conditions. This treatment is usually applied for difficulty in breathing. The use of mechanical ventilation devices has unique benefits to the patient. However, it can also cause various problems. Reduction in communication rank as one of the most negative experiences in mechanically ventilated patients. Effective communication with ventilator-based patients is essential. Nursing management of a mechanically ventilated patient is challenging on many levels, requiring a wealth of high technical skills. The Patient Communications Board improves communication, maintains information and creates a comfortable, attractive setting for patient, family and health care workers. The research methodology used for the study is a Quasi experimental approach, post-test only design with a comparison group to assess the effect of the communication board on the level of satisfaction over communication among clients on mechanical ventilator. The sample was selected by purposive sampling technique and included 30 (experimental group-15, control group-15), mechanically ventilated patients in PESIMR hospital, Kuppam. The control group patients were provided with routine communication methods, while the experimental group were communicated with communication board. The level of satisfaction on communication was assessed by a 15items rating scale. Data was analysed using both the descriptive and inferential statistics. There was a significant difference in the level of satisfaction on communication among the patients who were communicated using communication board compared to the routine method of communication. The communication board had significantly improved the communication pattern and increased the satisfaction among the patients who are mechanically ventilated.

scholarly journals EARLY PROBIOTICS IN PREVENTING VENTILATOR-ASSOCIATED PNEUMONIA AFTER MULTIPLE TRAUMA

2020 ◽  
pp. 83-85
Author(s):  
TAMER HABIB ◽  
AMIRA B KASSEM ◽  
ISLAM AHMED
Keyword(s):  
Multiple Trauma ◽  
University Hospital ◽  
Control Group ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Mechanically Ventilated ◽  
Significant Difference ◽  
Multiple Trauma Patients ◽  
And Control

Objective: Using probiotics in preventing ventilator-associated pneumonia (VAP) remain controversial due to different intensive care unit (ICU) populations included in such studies. The aim of this study is to evaluate the role of probiotics in prophylaxis of VAP after multiple trauma. Methods: Sixty-five adult multiple trauma patients on mechanical ventilator (expected ≥48 h) after admission to the Critical Care Medicine Department, Alexandria Main University Hospital from June to November 2018. Patients were randomly assigned using computer sheet into two groups; probiotics group (32 patients received one Lacteol Forte® sachet through orogastric/nasogastric tube 3 times daily during their ICU stay) and control group (33 patients received similar regimen of placebo sachets). All patients were followed up and subjected to all possible strategies of the diagnosis of microbiologically confirmed VAP. Results: Sixty-five patients were enrolled with a mean of age (39.48±7.692) years, 80% of them were male. Regarding the incidence of VAP, it was 18.46% of all patients without statistically significant difference between probiotics group (15.63%) and control group (21.21%) (p=0.751). Conclusion: Routine use of early probiotics in mechanically ventilated multiple trauma patients was not associated with lower incidence of VAP, duration of MV, or ICU mortality.

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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