| Semirecumbent positioning in ventilator-dependent patients: a multicenter, observational study. | |
| | |
MedLine Citation:
|
PMID: 21041187 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
BACKGROUND: Positioning of patients is a modifiable risk factor for ventilator-associated pneumonia. Current guidelines for prevention of ventilator-associated pneumonia recommend semirecumbency at 30º, with 45º preferable unless contraindicated. OBJECTIVE: To assess the use of semirecumbency for ventilator patients in Australian and New Zealand intensive care units. METHODS: In a multicenter, observational study, backrest elevation, mean arterial pressure, use of inotropic agents, enteral feeding, and weaning status were recorded 3 times per day by using a predetermined randomization schedule for 7 consecutive days (maximum 21 observation episodes). Severity of illness was recorded daily by using the Sepsis-Related Organ Failure Assessment (SOFA) score. RESULTS: Measurements (n = 2112) were recorded for 371 ventilator patients in 32 intensive care units. Backrest elevation at ≥45º was noted for 112 of 2112 (5.3%; 95% confidence interval [CI], 4.3-6.3) measurements; elevation ≥30º but <45º for 472 of 2112 (22.3%; 95% CI, 20.6-24.1). Contraindications to semirecumbency were noted during 447 measurements. Increased back-rest elevation occurred during enteral feeding (2.2º, P < .001) and weaning (3.1º, P < .001). Decreased backrest elevation was associated with inotropic support (2.8º, P < .001), decreased mean arterial pressure (0.7º/10 mm Hg, P < .001), and organ failure (0.5º/1-point increment in SOFA(max) score, P < .001). For measurements recorded with no contraindication to semirecumbency, weaning status (P = .003) and SOFA(max) score (P = .008) remained associated with the degree of backrest elevation. CONCLUSIONS: The findings of this multicenter, observational study suggest that backrest elevation was less than recommended and was influenced by clinical practices and patient condition. |
| | |
Authors:
|
Louise Rose; Ian Baldwin; Tom Crawford; Rachael Parke |
Related Documents
:
|
18368617 - Acute toxic effects of inhaled dichlorvos vapor on respiratory mechanics and blood chol... 2077987 - Ineffective ventilation during conscious sedation due to chest wall rigidity after intr... 10145567 - Compression volume in adult ventilator circuits: a comparison of five disposable circui... 18798557 - Noninvasive ventilation in large postoperative flail chest. 8125567 - Relation of pulse pressure and blood pressure reduction to the incidence of myocardial ... 21784887 - Inhibition of smooth muscle myosin as a novel therapeutic target for hypertension. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: American journal of critical care : an official publication, American Association of Critical-Care Nurses Volume: 19 ISSN: 1937-710X ISO Abbreviation: Am. J. Crit. Care Publication Date: 2010 Nov |
Date Detail:
|
Created Date: 2010-11-02 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9211547 Medline TA: Am J Crit Care Country: United States |
Other Details:
|
Languages: eng Pagination: e100-8 Citation Subset: IM; N |
Affiliation:
|
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada. louise.rose@utoronto.ca |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Invited commentary.
Next Document: Cleaned, ready-to-use, reusable electrocardiographic lead wires as a source of pathogenic microorgan...