闭式和开放式气管吸引预防三级医院重症监护病房患者呼吸机相关性肺炎的疗效观察

Ruksar Mulla, V. Mohite
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引用次数: 0

摘要

背景:气管内抽吸是一种常用于机械通气患者气道分泌物清洁的方法。本研究旨在比较开放式和封闭式抽吸方法对呼吸机相关性肺炎(VAP)发生的影响。在开放式气管内抽吸中,该方法需要两名护士的参与,并且可能由于患者在抽吸过程中与通气装置断开而导致通气和氧气供应的瞬时中断。在封闭式气管内抽吸中,该方法可以通过封闭式抽吸装置中的连接来执行,同时在不将患者与呼吸机分离的情况下对患者进行通气。目的:(1)。比较闭式和开放式气管内抽吸预防VAP的效果。(2) 评估插管患者中VAP的发生率。材料与方法:对60例在三级甲等医院重症监护室使用机械通气机的患者进行研究。本研究采用简单的随机抽样技术进行样本选择。采用抽签抽样的方法,在纳入标准的基础上,实验组和对照组各一人。结果:这项研究是针对三级护理医院重症监护室使用机械呼吸机的患者进行的。数据分析采用描述性和推断统计学方法。研究发现,在患者开放式气管内抽吸第1天和第2天的VAP评分中,开放式气管吸引没有显著变化,然后接受零假设(t=0.9,P=0.37),无效假设下开放式气管内抽吸方法有显著变化(P<0.05),结论:本研究评估了开放式气管内抽吸与封闭式气管内抽吸器在年龄、性别、住院时间、机械通气恢复时间和通气方式方面的疗效并不显著,但机械通气的持续时间显著。护士在进行抽吸以预防心肺并发症的同时,在评估心脏监测仪方面发挥着至关重要的作用。
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Efficacy of closed and open endotracheal suction on prevention of ventilator-associated pneumonia on patients admitted to critical care unit at tertiary care hospital
Background: Endotracheal suctioning is a method commonly used to clean airway secretions in patients under mechanical ventilation. This study aimed to compare the effects of open and closed suction methods on the occurrence of ventilator-associated pneumonia (VAP). In the open endotracheal suction, the approach necessitates the participation of two nurses and may result in a momentary interruption of ventilation and oxygen supply due to the patient's disconnection from the ventilation device during suctioning. In the closed endotracheal suction, the approach can be performed through connections in a closed suction set while the patient is ventilated without separating the patient from the ventilator. Objective: (1). To compare the close endotracheal suction with open endotracheal suction for the prevention of VAP. (2) To assess the incidence of VAP among intubated patients. Materials and Methods: The study was conducted among 60 patients who are on mechanical ventilator in the critical care unit in tertiary care hospital. For the study, simple random sampling technique is used for the selection of sample. Using a lottery method of sampling, one in the experimental group and one in the control group on the basis of inclusion criteria. Results: The study was done on patients who are on mechanical ventilators in the critical care unit in tertiary care hospitals. The data analysis was done using descriptive and inferential statistics. The study finding revealed that in VAP scoring of the patient's 1st and 2nd day in open endotracheal suction, there are no significant changes in open endotracheal suction then null hypothesis was accepted (t = 0.9, P = 0.37). VAP scoring of the patient's 2nd and 3rd day and 3rd and 1st day in open endotracheal suction, there are significant changes in open endotracheal suction method in null hypothesis was rejected (P < 0.05). VAP scoring of the patient's 1st and 2nd day and 2nd and 3rd day and 3rd and 1st day in closed endotracheal suction, there are significant changes in closed endotracheal suction then null hypothesis was rejected (P < 0.05). Conclusion: The study assessed the efficacy of open endotracheal suction versus closed endotracheal suction on age, sex, duration of hospital stays, return of mechanical ventilation, and mode of ventilation are not significant but the duration of mechanical ventilation is significant. The nurses play a vital role in assessing the cardiac monitor while doing suctioning to prevent cardiorespiratory complications.
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