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IRCT2013042913179N1 IRCT 2013-08-04 Vice chancellor for research, Isfahan University of Medical Sciences prevention of ventilator associated pneumonia Effect of intermittent subglottic secretions drainage combined with closed endotracheal suctioning in comparison with open endotracheal suctioning on incidence of ventilator associated pneumonia in intubated patients in Al-Zahra hospital intensive care units,Isfahan University of Medical Sciences. 2012-11-15 anticipated 64 Complete https://irct.ir/trial/13126 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Prevention, Other design features: Drainage of secretions around the endotracheal tube cuff was performed with inspiratory pause maneuver. The patient was blinded to intervention due to the anesthesia. Infectious disease specialist who was responsible for determining ventilator-associated pneumonia was blind to the grouping. the researcher were aware of the grouping. N/A Ventilator Associated Pneumonia. Intervention 1: Interventions in the Intervention group consist of closed suction system, 72-hour for endotracheal suctioning and subglottic secretions drainage. Every 3 hour, after oral full suction, the cuff of the endotracheal tube was connected to a cuff pressure gauge manometer. Inspiratory hold with use of inspiratory pause key that embedded in ventilator was performed. This key can hold breathing for 7 seconds and hyperinflated the lungs, in 3 seconds of holding the key, endotracheal tube cuff was depleted and pressure of air that trapping in the lungs, causing secretions to be pushed into the oral cavity. Tracheal tube cuff inflated in 6th second and the pressure was adjusted between 25 and 30 cm H2O. Oral cavity was cleaned with frequent suctioning. This maneuver was applied every three hours and immediately before the closed suction. For a closed suction, a suction catheter package that is used for 72hr was used. After identifying that the patient needs to be suctioned, Suction was attached to the suction connector and negative pressure was set to 200 cm H2O. Catheter sent into the patient's airway and after suction, catheter was removed. Intervention 2: In the control group, open suctioning was performed in sterile method, and subglottic secretions drainage was not performed.
public Rahimeh safdari
Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Azadi Square, Hezar-Jerib street, Isfahan
Isfahan Iran (Islamic Republic of) 73461-81746 +98 31 1792 2941 safdari@nm.mui.ac.irraha.safdari@yahoo.comsafdari8822@yahoo.com Isfahan University of Medical Science scientific Ahmadreza Yazdannik
Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Azadi Square, Hezar-Jerib street, Isfahan
Isfahan Iran (Islamic Republic of) 8174673548 +98 31 1792 2941 Yazdannik@nm.mui.ac.ir Isfahan University of Medical Sciences Iran (Islamic Republic of) inclusion criteria: Patients 18 to 60 years, mechanical ventilation more than 48 hr,free of pneumonia before intubation, exclusion criteria:death before 48 hr, extubation before end of study, surgery during the study period. 18 years 60 years Both J95.9 Postprocedural respiratory disorder, unspecified Prevention Prevention Interventions in the Intervention group consist of closed suction system, 72-hour for endotracheal suctioning and subglottic secretions drainage. Every 3 hour, after oral full suction, the cuff of the endotracheal tube was connected to a cuff pressure gauge manometer. Inspiratory hold with use of inspiratory pause key that embedded in ventilator was performed. This key can hold breathing for 7 seconds and hyperinflated the lungs, in 3 seconds of holding the key, endotracheal tube cuff was depleted and pressure of air that trapping in the lungs, causing secretions to be pushed into the oral cavity. Tracheal tube cuff inflated in 6th second and the pressure was adjusted between 25 and 30 cm H2O. Oral cavity was cleaned with frequent suctioning. This maneuver was applied every three hours and immediately before the closed suction. For a closed suction, a suction catheter package that is used for 72hr was used. After identifying that the patient needs to be suctioned, Suction was attached to the suction connector and negative pressure was set to 200 cm H2O. Catheter sent into the patient's airway and after suction, catheter was removed. In the control group, open suctioning was performed in sterile method, and subglottic secretions drainage was not performed. Incidence of Ventilator Associated Pneumonia. Timepoint: Before intubation, day 1, day 2, day 3, day 4, day 5,. Method of measurement: Clinical Pulmonary Infection Score, CPIS. Vice chancellor for research, Isfahan University of Medical Sciences Approved 2012-10-28 Medical Ethics Committee of Isfahan university of medical science. Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Azadi Square, Hezar-Jerib,Isfahan Isfahan Isfahan Iran, Islamic Republic Of 461-81746 Isfahan Iran (Islamic Republic of)