Abstract
Background: Late-onset ventilator associated pneumonia is leading pulmonary infection in mechanically ventilated patients.
Objective: To assess the effect of manual hyperinflation and suction techniques in patients receiving mechanical ventilation to prevent the risk of ventilator-associated pneumonia.
Method: Mechanically ventilated and intubated patient s (n = 30) included in this single-blind randomized trial were randomized into control and study group (lottery method). Patients were assessed for baseline parameters and airway clearance before (Day 1; pretest scores) and after (Day 3 and 5; post test scores) the test. Manual hyperinflation (15 min) and suctioning (15 sec) was administered in study group (n=15) whereas control group (n=15) was given suctioning (15 sec) as a routine nursing care, three times a day for 5 days. Data was analyzed by using SPSS 16; P<0.05 was statistically significant difference.
Results: Significant difference was observed in the airway clearance, on day 5 in the study group as compared to the control group (P< 0.001)).Effect of combination therapy was also found to be significant (P< 0.05) between the groups.
Conclusion: Routine and supportive airway management care for ventilated patients to prevent ventilator-associated pneumonia could be implemented with the help of the outcome of present study.
Keywords: Manual hyperinflation, Suctioning, Airway clearance.
References
- Goel V, Hogade SA, Karadesai S. Ventilator associated pneumonia in a medical intensive care unit: Microbial aetiology, susceptibility patterns of isolated microorganisms and outcome. Indian J Anaesth 2012:56: 558-562.doi:10.4103/0019-5049.104575
- Koenig SM, Truwit JD. Ventilator-associated pneumonia: diagnosis, treatment, and prevention. Clin Microbiol Rev 2006:19:637-657.doi:10.1128/CMR.00051-05
- Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002, 165, 867-903. doi:10.1164/ajrccm.165.7.2105078
- Rea-Neto A, Youssef NC, Tuche F, Brunkhorst F, Ranieri VM, Reinhart K, et al.Diagnosis of ventilator-associated pneumonia: a systematic review of the literature. Crit Care 2008:12: R56. doi:10.1186/cc6877
- Diaz E, Rodriguez AH, Rello J. Ventilator-associated pneumonia: issues related to the artificial airway. RespirCare 2005:50:900-906; discussion 6-9.
- Choi JS, Jones AY.Effects of manual hyperinflation and suctioning in respiratory mechanics in mechanically ventilated patients with ventilator-associated pneumonia. Aust J Physiother 2005:51:25-30.
- Brazier D. Effects of Manual Lung Hyperinflation Using Rebreathing Bags on Cardiorespiratory Parameters in Intubated Adults. Phys Ther Rev 2003:8:135-141. doi:10.1179/108331903225002461
- Clini E, Ambrosino N. Early physiotherapy in the respiratory intensive care unit. Respir Med 2005: 99: 1096-1104. doi:10.1016/j.rmed.2005.02.024
- El-Rhman EHA, Mohamed A, Shendy, Ahmed H. Effects of Manual Hyperinflation and Suction on Lung Compliance in Ventilated Patients in Different Positions. World Journal of Medical Sciences 2015:12:297-302. doi:10.5829/idosi.wjms.2015.12.3.962
- Pattanshetty RB, Gaude GS.Effect of multimodality chest physiotherapy in prevention of ventilator-associated pneumonia: A randomized clinical trial. Indian J Crit Care Med 2010:14:70-76. doi:10.4103/0972-5229.68218
- Ntoumenopoulos G, Presneill JJ, McElholum M, Cade JF. Chest physiotherapy for the prevention of ventilator-associated pneumonia. Intensive Care Med 2002:28:850-856. doi:10.1007/s00134-002-1342-2.
Corresponding Author
Milka Madhale
Department of Medical and Surgical Nursing, KLE University’s Institute of Nursing Sciences, Nehru Nagar, Belgaum-590010, Karnataka, India