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每日镇静中断方案对重症监护病房接受机械通气患者呼吸机相关性肺炎早期发病率的影响。

The effect of daily sedation interruption protocol on early incidence of ventilator-associated pneumonia among patients hospitalized in critical care units receiving mechanical ventilation.

作者信息

Shahabi Mehdi, Yousefi Hojatollah, Yazdannik Ahmad Reza, Alikiaii Babak

机构信息

Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Ulcer Repair Research Center, Department of Adult Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Iran J Nurs Midwifery Res. 2016 Sep-Oct;21(5):541-546. doi: 10.4103/1735-9066.193420.

Abstract

BACKGROUND

Ventilator-associated pneumonia (VAP) is a common side effect in patients who receive intravenous sedation infusion. In routine care, after starting sedation infusion for patients who receive mechanical ventilation, interruption of sedation starts without protocol. This study aimed to evaluate the effect of daily sedation vacation protocol on the incidence of VAP in mechanically ventilated patients.

MATERIALS AND METHODS

In this clinical trial study, 80 patients with intravenous sedation infusion were selected and randomly allocated to intervention and control groups. In the intervention group, daily sedation vacation protocol and in the control group, routine sedation vacation was followed. Modified clinical pulmonary infection score questionnaire was completed before intervention and on the third, fourth, and fifth days after intervention. Data were analyzed by using repeated measures analysis of variance (ANOVA), Chi-square, and independent -test.

RESULTS

The results of this study showed that the incidence rate of VAP in the intervention and control groups was 0% versus 15% on the third day of intervention, 12.5% versus 50% on the fourth day, and 27.5% versus 55.3% on the fifth day of intervention in the intervention and control groups, respectively. The incidence of VAP in the intervention group was significantly lower than in the control group ( < 0.05).

CONCLUSIONS

The results of this study showed that in patients with intravenous sedation, infusion of a daily sedation vacation protocol may reduce the incidence of VAP. Therefore, in order to prevent VAP, nurses are recommended to use this daily sedation vacation protocol.

摘要

背景

呼吸机相关性肺炎(VAP)是接受静脉镇静输注患者的常见副作用。在常规护理中,对接受机械通气的患者开始镇静输注后,镇静中断无规范流程。本研究旨在评估每日镇静中断方案对机械通气患者VAP发生率的影响。

材料与方法

在这项临床试验研究中,选取80例接受静脉镇静输注的患者并随机分为干预组和对照组。干预组采用每日镇静中断方案,对照组采用常规镇静中断方法。在干预前以及干预后第3、4、5天完成改良临床肺部感染评分问卷。数据采用重复测量方差分析、卡方检验和独立样本t检验进行分析。

结果

本研究结果显示,干预组和对照组在干预第3天的VAP发生率分别为0%和15%,第4天分别为12.5%和50%,第5天分别为27.5%和55.3%。干预组的VAP发生率显著低于对照组(P<0.05)。

结论

本研究结果表明,对于接受静脉镇静的患者,采用每日镇静中断方案可能会降低VAP的发生率。因此,为预防VAP,建议护士使用这种每日镇静中断方案。

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Ventilator-associated pneumonia and its prevention.呼吸机相关性肺炎及其预防。
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Ventilator-associated pneumonia: current status and future recommendations.呼吸机相关性肺炎:现状与未来建议。
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