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Does Head Of The Bed Elevation Of 45 Degrees Vs Supine Position Prevent Aspiration And The Development Of Pneumonia In Ventilator Dependent Patient's?

1475 words - 6 pages

Pneumonia is an infection that causes the air sacs in one or both of the lungs to become inflamed. These air sacs are responsible for gas exchange. When they are filled with fluid or pus this causes a cough and difficulty of breathing. Many things such as aspiration, a prolonged hospital stay, bacteria, fungi, or viruses including the common cold can cause pneumonia. Some of the risk factors for developing pneumonia are age greater then 65, weakened immune system, smokers, chronic diseases, or people who have been placed on a ventilator. Complications of pneumonia are getting bacteria in the blood stream, lung abbesses, fluid accumulation in the lungs, or getting poor oxygenation. The signs ...view middle of the document...

Researchers question whether or not having the head of the bed elevated may prevent ventilator-acquired pneumonia
Ventilator-acquired pneumonia can have many effects on a patient. Physically they patient will be tired, have a weaken immune system, any may feel anxious due to the consistent shortness of breath. Socially they may feel isolated due to the inability to talk or minimal communications. The prolong hospital stay can cause a build up of bills and more stress for the patient and family. The nurses will have to take extra precautions when taking care of a patient who is ventilated and had pneumonia. Protective isolation many be initiated. The hospital will have to use more resources to prevent furthering the infection and how this patient acquired pneumonia. People who develop ventilator-acquired pneumonia have a large increase in mortality rate. So what does research say about intervention hospital personal can take to prevent ventilator-acquired pneumonia.
One evidenced based study did preform a randomized trail of a group of 30 intubated patients randomly placed in either a 20 or 45-degree angle. This study was done in 2007 but revised in 2012. The goal of this study was to see if there was a decrease in incidences of ventilator-acquired pneumonia in patients with their head of the bed elevated to a 45-degree angle. Of the 30 patients 17 were in the treatment group and 13 in the control group. The treatment group had their head kept at a 45-degree angle throughout the entire study and hospital stay. There were inclusion and exclusion criteria that were used to select the groups. Some of the inclusion criteria was consent by the patient or relative and intubated within 12 hours of the start of the study. The exclusion criteria consisted of intubation within the last 30 days, unable to tolerate 40 degree angle, sever obesity, require position changes, unstable blood pressure, pregnancy, spinal trauma, or intubate more than 12 hours prior to study. All patients were supported with one pillow beneath their head as a comfort measure. There was a follow up period of 72 hours after exintubation. Chest x-rays were done only on patients who had evidence of possible signs of pneumonia. Results showed “that 29% (five) in the treatment group and 54% (seven) in the control group contracted ventilated–acquired pneumonia” (Keeley, 2012). Out of the 12 patients who developed ventilated–acquired pneumonia, eight died. Of the five in the treatment group patients who developed ventilated–acquired pneumonia, four died. From the control group of seven patients who developed ventilated–acquired pneumonia, four died. They researchers stated, “ the ICU mortality rate of those patients who developed ventilated–acquired pneumonia was 50%, with a hospital mortality rate of 58%” (Keeley, 2012). They concluded that there was a decrease in ventilated acquire pneumonia in patient who’s head was at a 45 degree angle rather then those who were in a supine position....

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