The Effect of Suction System Flushing With Chlorhexidine on the Occurrence of Ventilator-Associated Pneumonia Among Mechanically Ventilated Patients
试验速览
- 阶段
- 早期 1 期
- 状态
- 已完成
- 入组人数
- 136
- 试验地点
- 2
- 主要终点
- VAP Incidence
研究概览
简要总结
Background: Standard practice of flushing saline over the patient's secretions following suctioning is similar to pouring water over grease, leading to motivating bacterial colonization and proliferation inside the suctioning circuit (i.e., catheter, tube, and collecting jar), which can then migrate to patient's lung during suctioning procedure causing ventilator-associated pneumonia (VAP). Therefore, flushing this circuit using an appropriate disinfectant to prevent bacterial colonization inside it and thus decreasing pneumonia occurrence has been our crucial investigation idea.
Aim: To investigate the effect of suction system flushing with chlorhexidine (CHX) on the occurrence of VAP among mechanically ventilated patients (MVPs). Design: This study adopted a quasi-experimental research design, and a convenience sampling technique was used to recruit 136 patients to conduct this study. Setting: This study was conducted at surgical intensive care units of Mansoura University Emergency Hospital, Egypt. Results: The intervention group patients had a lower incidence of VAP (by 48.12%) compared with the control group. Moreover, the proposed technique was more effective in decreasing the incidence of late-VAP more than early-VAP. Furthermore, CHX reduced the cost of suction system flushing by 75%. Conclusion: Suction system flushing with CHX can significantly reduce the occurrence of VAP among MVPs and reduce the flushing cost. Therefore, this study recommends incorporating CHX into the daily care of MVPs.
详细描述
Research question Does OTSS flushing with CHX reduce the occurrence of VAP among MVPs?
Hypothesis OTSS flushing with CHX will reduce the occurrence of VAP among MVPs compared with traditional flushing using normal saline.
Aim This study aimed to investigate the effect of OTSS flushing with CHX on the occurrence of VAP among MVPs.
Research design A quasi-experimental research design was adopted to conduct this study. The subjects were randomly assigned to either the intervention or control group, and comparative results were analyzed based upon pre-post intervention follow-up for both groups.
Setting This study was conducted at the surgical ICUs affiliated with a university hospital in Egypt with 201-bed capacity. There are three surgical ICUs participated in the study; each one has 10 beds and provides care to patients with surgical and neurological problems, and multiple trauma injuries. These units are well equipped with advanced technology required for high quality patients' care. The nurse-patient ratio in these units is nearly 1:2.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 14 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All adult patients admitted to the afore-mentioned ICUs who were intubated within the previous 24 hours and were expected to receive MV support for more than 48 hours were recruited in the study.
排除标准
- •Patients with a clinical diagnosis of pneumonia at the time of admission and/or modified CPIS of 5 or greater.
- •Patients who were previously intubated during the current hospital admission.
- •Patients who had contraindications to suctioning such as severe hemoptysis, increased intracranial pressure, and cerebrospinal fluid leaks.
- •Patients with pulmonary edema, ARDS, and those with atelectasis were also excluded from the study because of their pulmonary infiltrate disease pathophysiology.
- •Patients known to be allergic to CHX were also eliminated from the study.
结局指标
主要结局
VAP Incidence
时间窗: an average of 7 months
Occurrence of Ventilator Associated Pneumonia
次要结局
未报告次要终点
研究者
Mohamed Hesham Eid
Assistant Lecturer
Mansoura University