|Title:||A randomized controlled trial comparing continuous oral suctioning with a mouldable saliva ejector to the routine ventilator care for preventing ventilator-associated pneumonia : a pilot study|
|Subject:||Hong Kong Polytechnic University -- Dissertations|
Intensive care units
Respirators (Medical equipment)
Nosocomial infections -- Prevention
|Department:||School of Nursing|
|Pages:||ix, 85, xvi leaves : ill. ; 31 cm.|
|Abstract:||Background: Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality for patient in Intensive care unit (ICU). The duration of mechanical ventilation, length of ICU stay, length of hospital stay will be increased once a patient acquired VAP. Various measures are adopted to prevent VAP and a costly endotracheal tube with a dorsal lumen that drains the subglottic secretion is often recommended. Objectives: The objectives of this study are to determine if the application of continuous oral suctioning (COS) is associated with a decreased incidence of VAP when compared with routine ventilatory care without COS; and to compare the VAP free time, duration of mechanical ventilation, length of ICU stay, length of hospital stay, and mortality rate between ventilated patients receiving COS and those receiving routine ventilatory care without COS. Method: This is a randomized controlled trial, conducted in a 6-bed ICU of a private hospital in Hong Kong from 1st September 2009 to 15th March 2010. Patients were randomly assigned to receive either COS or routine ventilatory care without COS. Outcome Measures: The primary end-point was the comparison of the rate of VAP between the two groups. Secondary outcome variables included the VAP free time, duration of mechanical ventilation, length of ICU stay, the length of hospital stay, and the mortality rate. Results: Twenty five patients were enrolled in this study. Thirteen patients were randomized to receive COS and 12 patients were randomized to the control group. Two groups were similar in demographics, reasons for intubation, co-morbidity and risk factors for acquiring VAP. Ventilator-associated pneumonia was found in 3 patients (23.1 %) receiving COS and in 10 patients (83.3%) in the control group (p=0.003). The VAP free time was 4.7±2.4 for the treatment group and 2.4±O.6 for the control group (p=0.000). The duration of mechanical ventilation of treatment group and control group was 3.2±1.5 versus 5.9±2.8 days and the length of ICU stay was 4.8±1.6 versus 9.8±6.3 days (p<0.005). There was no significant difference found in the length of hospital stay and mortality rate between the two groups. Conclusion: Continuous oral suctioning could reduce the incidence of VAP. It could also increase VAP free time, decrease the duration of mechanical ventilation and length of ICU stay.|
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