Effects of 60° Semi-recumbent Position on Preventing Ventilator-associated Pneumonia: A Single-blind Prospective Randomised Clinical Trial
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 12
Abstract
Introduction: Head-of-Bed Elevation (HOBE) is now considered as a main modifiable factor for decreasing Ventilator-Associated Pneumonia (VAP) especially in the area of intensive care nursing. Despite numerous studies on the beneficial effects of different HOBE, there is little scientific evidence examining the effect of a 60° HOBE position. Aim: The present study aimed to examine the effect of 60° HOBE on preventing VAP and respiratory parameters in mechanically ventilated patients. Materials and Methods: In a single-blind prospective randomised clinical trial, 25 patients were recruited in the multidisciplinary surgical intensive care unit over a period of a year (June 2011 to April 2012), and randomly assigned to the intervention group maintaining position of 60° (n=14) and the control group in the routine position of 45° (n=11). VAP and respiratory parameters (tidal volume, pulmonary compliance, pulmonary resistance, and respiratory rate) were investigated from first to the seventh day of intubation. Results: HOBE at 60° resulted in significantly lower pulmonary infiltration on chest X-ray (p=0.009), lower axillary temperature (p=0.001), as well as higher tidal volume (p<0.001) and higher pulmonary compliance (p=0.038) compared with the control group. The overall prevalence of VAP was 20% in the intervention group and 73% in the control group (p=0.016). In this regard, HOBE from 45° to 60° reduced the risk of VAP more than three times. Conclusion: HOBE at 60° results in a significant decrease in the occurrence of VAP and also improvement in some mechanical respiratory parameters including tidal volume and pulmonary compliance.
Authors and Affiliations
Hadi Hassankhani, Sharzad Akbarzadeh, Sima Lakdizaji, Atabak Najafi, Ebrahim Aliafsari Mamaghani
Keywords
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- EP ID EP367968
- DOI 10.7860/JCDR/2017/27443.11007
- Views 48
- Downloads 0
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