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Evid Based Nurs 9:117 doi:10.1136/ebn.9.4.117
  • Treatment

A target backrest elevation of 45° was not feasible for mechanically ventilated patients; elevations achieved did not prevent ventilator associated pneumonia


 
 Q In critically ill patients on mechanical ventilation, is a semirecumbent position of 45° feasible and effective for prevention of ventilator associated pneumonia (VAP)?

METHODS

GraphicDesign:

randomised controlled trial.

GraphicAllocation:

concealed.

GraphicBlinding:

blinded (outcome assessors).

GraphicFollow up period:

median 5–6 days (range 0–64 d).

GraphicSetting:

4 intensive care units (ICUs) in 3 university hospitals in the Netherlands.

GraphicPatients:

221 adults (mean age 64 y, 63% men) who were intubated within 24 hours of ICU admission and had an expected duration of ventilation ⩾48 hours.

GraphicIntervention:

semirecumbent position (backrest 45° from horizontal) (n = 112) or supine position (10°) (n = 109) for the duration of ventilation. A nurse adjusted the backrest of the bed to the allocated position 2–3 times daily, but it could be changed at patient request or as required for care.

GraphicOutcomes:

microbiologically confirmed VAP, pressure …

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