Secretion clearance strategies in Australian and New Zealand Intensive Care Units

被引：38
作者：
Ntoumenopoulos, George [1 ,2 ]
Hammond, Naomi [3 ,4 ,5 ]
Watts, Nicola R. [3 ]
Thompson, Kelly [3 ,4 ]
Hanlon, Gabrielle [8 ]
Paratz, Jennifer D. [6 ,7 ]
Thomas, Peter [7 ]
机构：
[1] St Vincents Hosp, Sydney, NSW, Australia
[2] Univ Technol Sydney, Discipline Physiotherapy Grad Sch Hlth, Sydney, NSW, Australia
[3] George Inst Global Hlth, Crit Care & Trauma Div, Newtown, NSW, Australia
[4] Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia
[5] Royal North Shore Hosp, Malcolm Fisher Dept Intens Care, St Leonards, NSW, Australia
[6] Griffith Univ, Menzies Res Inst, Nathan, Qld, Australia
[7] Royal Brisbane & Womens Hosp, Dept Physiotherapy, Herston, Qld, Australia
[8] Epworth Hosp Richmond, Intens Care, Richmond, Vic, Australia
来源：
AUSTRALIAN CRITICAL CARE | 2018年 / 31卷 / 04期
关键词：
Aspiration mechanical; Intensive care; Mechanical ventilation; Physical therapy modalities; Respiration artificial; Sputum; ENDOTRACHEAL-TUBE OBSTRUCTION; VENTILATED PATIENT; PHYSIOTHERAPISTS; ICU;
D O I：
10.1016/j.aucc.2017.06.002
中图分类号：
R4 [临床医学];
学科分类号：
1002 ; 100602 ;
摘要：
Introduction/aims: To describe the processes of care for secretion clearance in adult, intubated and mechanically ventilated patients in Australian and New Zealand Intensive Care Units (ICUs). Methods/results: A prospective, cross-sectional study was conducted through the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) Point Prevalence Program. Forty-seven ICUs collected data from 230 patients intubated and ventilated on the study day. Secretion clearance techniques beyond standard suctioning were used in 84/230 (37%) of patients during the study period. Chest wall vibration 34/84 (40%), manual lung hyperinflation 24/84 (29%), chest wall percussion 20/84 (24%), postural drainage/patient positioning 17/84 (20%) and other techniques including mobilisation 15/ 84 (18%), were the most common secretion clearance techniques employed. On average (SD), patients received airway suctioning 8.8 (5.0) times during the 24-h study period. Mucus plugging events were infrequent (2.7%). The additional secretion clearance techniques were provided by physiotherapy staff in 24/47 (51%) ICUs and by both nursing and physiotherapy staff in the remaining 23/47 (49%) ICUs. Conclusion: One-third of intubated and ventilated patients received additional secretion clearance techniques. Mucus plugging events were infrequent with these additional secretion clearance approaches. Prospective studies must examine additional secretion clearance practices, prevalence of mucus plugging episodes and impact on patient outcomes. Crown Copyright (C) 2017 Published by Elsevier Ltd on behalf of Australian College of Critical Care Nurses Ltd. All rights reserved.
引用
收藏
页码：191 / 196
页数：6
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