Application of a management plan for microaspiration of oropharyngeal secretions in ICU patients with tracheal intubation
10.3761/j.issn.0254-1769.2024.10.001
- VernacularTitle:口咽分泌物微误吸管理方案在ICU气管插管患者中的应用研究
- Author:
Wei DENG
1
;
Xiaozhen LI
;
Ying WANG
;
Liping TAN
;
Baochun ZHOU
;
Fengmei TIAN
;
Hui HUANG
;
Jie ZOU
;
Wen TANG
;
Sujuan XU
Author Information
1. 215004 苏州市 苏州大学附属第二医院重症医学科
- Keywords:
Intensive Care Units;
Intubation,Intratracheal;
Oropharyngeal Secretions;
Microaspiration;
Nursing Care
- From:
Chinese Journal of Nursing
2024;59(10):1157-1163
- CountryChina
- Language:Chinese
-
Abstract:
Objective To construct and apply a management plan for microaspiration of oropharyngeal secretions in ICU intubated patients.Methods Based on evidence summaries and expert consultation,a management plan for microaspiration of oropharyngeal secretions in ICU intubated patients was constructed,consisting of 19 items covering 7 aspects including identification of risk factors,position management,tube and cuff selection,cuff management,mechanical ventilation management,pain and sedation management,removal of oropharyngeal and subglottic secretions,and oral care.Convenience sampling was used to select 141 ICU intubated patients from a tertiary A comprehensive hospital in Suzhou from June,2022 to September,2023.Patients were divided into an experimental group(n=72)and a control group(n=69)according to the wards.The experimental group received the management plan for microaspiration of oropharyngeal secretions in ICU intubated patients.The control group received the nursing bundle for ventilator associated pneumonia(VAP).The incidence and time from intubation to microaspiration and VAP,duration of mechanical ventilation,ICU length of stay,and disease outcome were compared between the 2 groups.Results The incidence of microaspiration of oropharyngeal secretions,the duration of mechanical ventilation,time from intubation to microaspiration showed significant differences between the 2 groups(P<0.05).There were no significant differences in the incidence of ventilator associated pneumonia,ICU length of stay,and disease outcome between the 2 groups(P>0.05).The time from intubation to VAP in the experimental group was 7.5 days,and that in the control group was 3.8 days.Conclusion The application of the management plan for microaspiration of orophaiyngeal secretions in ICU intubated patients is beneficial for reducing the incidence of microaspiration,delaying the time from intubation to microaspiration and VAP,and shortening the duration of mechanical ventilation.
