Factors Hindering The Effect of The Nebulization Therapy among Critically Ill Mechanically Ventilated Patients

Abd Elrhman Sami Shabaan Eltabakh, Suad Elsman, Sahar El-Shenawi, A. Nabil
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Abstract

Background: Nebulization therapy is used for many therapies now including bronchodilators and corticosteroids and has a significant advantages superior to other routes of administration. However, it has many draw backs. Objective: To identify factors hindering the effect of nebulization therapy among critically ill mechanically ventilated patients. Settings: four intensive care units at Alexandria Main University. Subjects: A convenience sample of 60 adult critically patients on invasive MV and, all critical care nurses about 50 nurses who were involved in providing direct patient care and working in the three different shifts. Tool: “Factors hindering the effect of nebulization therapy among mechanically ventilated patients’ assessment” was used to collect the needed data. Results: Findings of the current study revealed that there was a significant improvement in almost cardiovascular and respiratory parameters (p=<0.001* for all) after the nebulization therapy session with 4 hours, while Majority of the nurses had unsatisfactory level of performance regarding to nebulization therapy especially in the night shift with significant value for total score (p=0.006* for all). Conclusion: slower inspiratory flow, longer duty cycle, and large diameter tracheal tubes gives betters and effective nebulization. Recommendations: Frequent check of the ventilator parameters and connections before nebulization therapy, also providing frequent inservice training programs for the nurses related to the correct technique for nebulization therapy administration.
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影响危重机械通气患者雾化治疗效果的因素
背景:雾化治疗现在被用于许多治疗,包括支气管扩张剂和皮质类固醇,具有明显优于其他给药途径的优势。然而,它也有很多缺点。目的:探讨影响危重机械通气患者雾化治疗效果的因素。环境:亚历山大大学的四个重症监护室。研究对象:60名接受有创MV治疗的成年危重患者和50名左右的危重护理护士,他们分别在三个不同的班次中提供直接护理。工具:采用“机械通气患者雾化治疗效果影响因素评估”收集所需数据。结果:本研究结果显示,在雾化治疗4小时后,大多数护士的心血管和呼吸参数均有显著改善(p=<0.001*),而大多数护士对雾化治疗的表现不满意,特别是夜班护士,总分显著(p=0.006*)。结论:较慢的吸气流量、较长的占空比、较大直径的气管插管使雾化效果更好。建议:在雾化治疗前经常检查呼吸机参数和连接,并经常为护士提供有关正确雾化治疗给药技术的在职培训。
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