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两种不同喂养方法对预防儿科重症监护病房(PICU)呼吸机相关性肺炎的影响:一项随机对照研究。

Effect of two different feeding methods on preventing ventilator associated pneumonia in the paediatric intensive care unit (PICU): A randomised controlled study.

作者信息

Sönmez Düzkaya Duygu, Yildiz Suzan

机构信息

Istanbul University, Istanbul Faculty of Medicine, Directorate of Nursing Services, Education Nurse, Çapa-Fatih, Istanbul, Turkey.

Istanbul University, Florence Nightingale Nursing Faculty, Pediatric Nursing Department, Istanbul, Turkey.

出版信息

Aust Crit Care. 2016 Aug;29(3):139-45. doi: 10.1016/j.aucc.2015.11.001. Epub 2015 Dec 2.

Abstract

BACKGROUND

For infants and children who require intubation in the paediatric intensive care unit (PICU), ventilator-associated pneumonia (VAP) is a significant cause of secondary morbidity and mortality linked with extended use of intubation. Nurses are primarily responsible for the prevention of VAP and there are a number of procedures that contribute towards this end. Although enteral nutrition has been reported to be effective in the prevention of VAP, this remains controversial.

OBJECTIVE

To compare and evaluate the effects of intermittent feeding through a nasogastric catheter with those of continuous feeding through a nasoduodenal catheter in preventing VAP in the PICU.

DESIGN

The research design was a randomised, controlled experimental study.

METHODS

Forty paediatric patients were randomised and divided into two groups of 20: one group for nasoduodenal (ND) feeding and the other for nasogastric (NG) feeding. Patients were assessed for the development of VAP using the clinical pulmonary infection score and Centers for Disease Control and Prevention criteria while working in accordance with the VAP prevention bundles introduced within the unit.

RESULTS

The incidence of paediatric VAP was 15%. The rate of VAP in patients who were ND fed was 10%, whereas the rate of VAP in patients who had NG feeding was 20%. No statistically significant difference was observed between the ND- and NG-fed patients (p=0.661).

CONCLUSION

Although the results of our study were not statistically significant, nasoduodenal feeding helped to reduce the incidence of VAP.

摘要

背景

在儿科重症监护病房(PICU)中,需要插管的婴幼儿患者发生呼吸机相关性肺炎(VAP)是与长时间插管相关的继发性发病和死亡的重要原因。护士主要负责预防VAP,有多种操作有助于实现这一目标。尽管有报道称肠内营养对预防VAP有效,但这一点仍存在争议。

目的

比较和评估经鼻胃管间歇性喂养与经鼻十二指肠管持续喂养在预防PICU中VAP方面的效果。

设计

研究设计为随机对照实验研究。

方法

40名儿科患者被随机分为两组,每组20名:一组采用鼻十二指肠(ND)喂养,另一组采用鼻胃(NG)喂养。在按照科室引入的VAP预防集束方案开展工作的同时,使用临床肺部感染评分和美国疾病控制与预防中心的标准对患者是否发生VAP进行评估。

结果

儿科VAP的发生率为15%。接受ND喂养的患者VAP发生率为10%,而接受NG喂养的患者VAP发生率为20%。接受ND喂养和NG喂养的患者之间未观察到统计学上的显著差异(p = 0.661)。

结论

尽管我们的研究结果在统计学上不显著,但鼻十二指肠喂养有助于降低VAP的发生率。

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