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Showing 8 results for Mechanical Ventilation
Nasim Mehranfard, Jaleh Mohammad Aliha, Mojdeh Navidhamidi, Anushirvan Kazemnejad, Kiarash Saatchi,
Volume 3, Issue 3 (12-2014)
Abstract
Aim. The purpose of this study was to examine the effect of acupressure on anxiety in patients under mechanical ventilation.
Background. Mechanical ventilation is a frequently used technological modality for patients in Intensive Care Unit (ICU), and this treatment has potential to produce a variety of unpleasant stress and physiological and psychological complications. Anxiety is one of the most common mental reactions in patients under mechanical ventilation. Acupressure as a non-pharmacological approach may improve anxiety in these patients without side effects.
Method. This was a randomized block experimental study in which 164 ventilated patients with stable hemodynamics and GCS≥9 who had study criteria were randomly allocated into experimental or control group. Patients in the experimental group received two sessions/day of acupressure along with routine care for two consecutive days, but patients in the control group received only routine care. The anxiety was measured with Faces Anxiety Scale (FAS), before, right after, and one hour following every acupressure session. The data were analyzed by SPSS software using descriptive and inferential statistics.
Findings. Baseline anxiety level was high in most of patients. Anxiety in the experimental group decreased significantly (p=0.032) when compared with control group, over time. Anxiety was significantly different between groups, right after intervention in every session of acupressure (p<0.0001). In the experimental group, time-dependent changes of anxiety was statistically significant (p<0.0001) and anxiety was significantly different before and right after intervention in every session of acupressure (p<0.0001). The amount of change in anxiety was not significantly different between sessions.
Conclusion. Acupressure therapy could reduce anxiety significantly in patients with mechanical ventilation. Critical care nurses can use this non-pharmacological approach to reduce anxiety in patients under mechanical ventilation.
Nikoo Niknafs, Jila Mirlashari, Parichehr Talori, Naser Bahrani,
Volume 4, Issue 1 (6-2015)
Abstract
Aim. This study aimed at examining the effect of nursing care training program on outcomes of mechanically- ventilated infants.
Background. Mechanical ventilation in infants is considered as an invasive procedures with complications such as bronchopulmonary dysplasia, lung bleeding, obstruction or removal of the endotracheal tube, which are almost all preventable. Nurse have responsibility to avoid these complications.
Method. This study was a randomized clinical trial (outcome-based). The study included all infants undergoing mechanical ventilation in the neonatal intensive care unit of Comprehensive Women's hospital in Tehran. Nurses were trained over one month at bedside by the clinical instructor. Data on ventilator complications were collected of 120 cases from patients' medical records, before and after intervention. The data were analyzed by SPSS version 21.
Findings: A statistical significant decrease was seen in most outcomes. The incidence of bronchopulmonary dysplasia declined from 35% to 18%, re-intubation decreased from 57% to 33%, pulmonary hemorrhage declined from 32% to 13%, and pneumothorax changed from 55% to 35%. Duration of mechanical ventilation and length of stay also decreased significantly after intervention. No statistically significant decrease was observed in retinopathy of prematurity and death.
Conclusion. Educational program, especially by the coach, is effective on most outcomes of the infants under mechanical ventilation. Taking into account the workload of nurses and problems with attending in educational classes outside of the ward, it is recommended to hold education at bedside for nurses to improve quality of education.
Mostafa Alavi, Tooraj Babaee, Mahshid Ghadrdoost, Alireza Azad,
Volume 4, Issue 4 (3-2016)
Abstract
Abstract Aim.This study aimed to compare pulse pressure variation (PPV) with central venous pressure (CVP) in checking out and optimizing fluid volume in mechanically ventilated patients admitted to intensive care unit after cardiac surgery. Background.In clinical area, assessment of body fluid and determination of the intravascular volume after major surgeries such as heart surgery is a significant challenge. The initial purpose of intravascular volume assessment in patients with hemodynamic instability is to determine whether they would benefit from fluid administration or not. Method. In the present study a prospective descriptive-analytic design was used. Thirty mechanically ventilated patients admitted to intensive care units of Rajaee Heart Center, Tehran, Iran, were recruited in the study after cardiac surgery based on inclusion criteria. Data collection tools included demographic and clinical data sheets. Hemodynamic parameters such as CVP, systolic and diastolic pressures (for calculating pulse pressure and its variation) were recorded by bedside monitoring. Cardiac Index (CI) was measured by non invasive continuous cardiac output monitoring (NICCOMO) system. Data were analyzed in SPSS version 20, using statistical tests. Findings. The mean changes of CVP, before and five minutes after fluid administration, were significantly different (10.10±6.01 mmHg and 12.37±6.34 mmHg, respectively, p=0.015). The mean changes in arterial pulse pressure, before and five minutes after fluid administration, were significantly different (16.94±8.32 mmHg and 12.77±4.02 mmHg, respectively, P=0.005). At the cut point 2.8 lit/min/m2 for CI, the sensitivity and specificity values for PPV>13%, were 0.71 and 0.61, respectively. Also, at the same cut point, the sensitivity and specificity values for CVP<5mmHg, were 0.11 and 0.84, respectively. These findings suggest a higher diagnostic power of PPV compared to CVP to assess fluid volume. Conclusion.It seems that in the mechanically ventilated patients after heart surgery, PPV dynamic index is preferred to CVP static index to evaluate and maintain fluid volume.
Masoumeh Zakeri-Moghadam, Hosein Bahadori Far, Zahra Abbasi, Hamid Haghani,
Volume 5, Issue 2 (9-2016)
Abstract
Abstract
Aim. The aim of this study was to examine the effect of music therapy on ventilation criteria in mechanically ventilated patients in the intensive care unit.
Background. Complications made by mechanical ventilation are so much and considerable. Improvement of ventilation criteria is one of the factors that facilitatesweaning from mechanical ventilation.
Method. This randomized controlled trial was conducted in intensive care units of a teaching hospital affiliated to Iran University of Medical Sciences, Tehran, Iran. Seventy patients were recruited based on inclusion criteria and randomly allocated to experimental (n=35) and control (n=35) groups. For experimental group, relaxing music therapy was played with headphone for 30 minutes, once in the morning and once in the afternoon for one day. For control group, headphone was used without music for 30 minutes, once in the morning and once in the afternoon for one day. In both groups, ventilation criteria of respiratory rate, peak airway pressure and arterial saturation of oxygen (SaO2) were recorded in four intervals. Data analysis was performed in SPSS version 18 using statistical test.
Findings. Comparing of trends of ventilation criteria in experimental group showed that music therapy significantly reduced the mean respiratory rate (p= 0.0001), while in the control group, the mean respiratory rate slightly increased with time. In experimental group, the mean airway pressure reduced significantly within 30 minutes (17.30±3.65) compared with the time zero (19.68±3.64) (p=0.001). In the control group, the mean airway pressure increased slightly. The amount of spo2 did not differ significantly between experimental and control group (P=0.051).
Conclusion. Implementing music therapy in mechanically ventilated patients admitted to intensive care unit can reduce respiratory rate and maximum airway pressure. These could reduce the work of breathing and facilitate weaning the patient from ventilators.
Mohsen Ziyaeifard , Ali Sadeghi, Rasool Ferasatkish , Mostafa Fatahi , Majid Basirat, Khadijeh Hashemi,
Volume 7, Issue 2 (9-2018)
Abstract
Abstract
Aim. This study was conducted to evaluate effect of bedside teaching on critical care nurses' performance in airway suctioning
Background. One of the most effective measures in patients undergoing mechanical ventilation is suctioning the trachea to prevent the accumulation of potentially infectious pulmonary secretions and to clear the airway which is carried out by critical care nurses. If suctioning cannot be correctly performed, some complications may occur.
Method. This was a quasi-experimental study in which the study sample consisted of 54 critical care nurses working in Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. The nurses were recruited through convenience sampling based on inclusion criteria. Critical care nurses’ performance in airway suctioning were evaluated before and two weeks after intervention using a checklist. The intervention included bedside teaching of suction procedure.
Findings. Two weeks after intervention, the mean score of performance in airway suctioning increased significantly (P≤0.0001). Hand washing or using hand was recorded only for 16 nurses before intervention and for 35 nurses after intervention. Maintaining catheter sterility during suctioning was considered by 28 nurses before intervention, and by 40 nurses after intervention. Correct procedure documentation and recording secretion characteristics before and after intervention were carried out by 13 and 34 nurses, respectively. While activating suction during bringing the catheter out of endotracheal tube was done by 31 nurses before intervention, after intervention 41 nurses did so.
Conclusion. Bedside teaching of correct airway suctioning for critical care nurses enhance their performance in this procedure.
Mohsen Ziyaeifard, Rasool Ferasatkish, Nahid Aghdaii, Ali Sadeghi, Mehrdad Haghazali, Fatemeh Barati, Sudabeh Rafiee,
Volume 8, Issue 1 (3-2019)
Abstract
Abstract
Aim. The aim of this study was to examine the effect of protocol of weaning from mechanical ventilation on the gastrointestinal function in people undergoing CABG.
Background. The most common problems after cardiac surgery in the intensive care unit are change in vital signs, respiratory problems, unsuccessful separation from mechanical ventilation, and gastrointestinal problems. Due to the numerous effects that gastrointestinal problems have on the patient after cardiac surgery and also the economic burden that these complications impose on the patient and the health care system, choosing the best technique to prevent and control these problems is critical for the health care team.
Method. The present study was a randomized clinical trial conducted on 100 people undergoing CABG. They were allocated to control and experimental group based on permuted block randomization. The control group received routine way and experimental group received protocol of weaning. The groups were compared in terms of nausea and vomiting, the time of beginning oral diet, defecation and bowel sounds before weaning 2, 6, and 12 hours after weaning from mechanical ventilation. Data were analyzed In SPSS version 23 using chi-square, Mann–Whitney U and Fisher tests.
Findings. In experimental group, there was a faster onset of bowel sounds and movements and earlier beginning of oral diet.
Conclusion. Patients who were under the protocol of weaning from mechanical ventilation had better gastrointestinal functional status compared to those who were under routine weaning.
Fateme Falamarzi, Shiva Khaleghparast, Mohammad Zia Totonchi , Mahmood Sheikh Fathollahi,
Volume 9, Issue 1 (3-2020)
Abstract
Abstract
Aim. This study was conducted to examine the effect of using Burn weaning checklist on the duration of mechanical ventilation and hemodynamic criteria in patients undergoing adult open heart surgery.
Background. Mechanical ventilation is an adjunct or alternative to spontaneous breathing. Due to the proximity of the circulatory and pulmonary systems, the balance of the mechanical ventilation system and the human cardiovascular system is complex, and its weaning must be planned.
Method. This randomized clinical trial study was performed on 80 patients admitted for open heart cardiopulmonary bypass surgery. After random assignment, in the control group, the weaning process was performed according to the routines by a physician, and in the experimental group, the weaning was performed by a Burn checklist by a physician and a nurse. Hemodynamic criteria (first and second hours upon arrival, first and second hours during weaning, first and second hours after weaning) and duration of mechanical ventilation were recorded and compared between experimental and control group. Data were analyzed in SPSS software version 22 using two-way repeated measures ANOVA.
Findings. The mean intubation duration in the experimental group (7.50±1.86 hours) was significantly less than the control group (11.30±3.39 hours) (P≤0.0001). The interaction between group and time for variables diastolic blood pressure (P=0.002), pulse pressure (P=0.003) and heart rate (P≤0.0001) was statistically significant.
Conclusion. The use of the Burn assessment checklist reduces the duration of weaning process in patients after adult open heart surgery. It also helps balancing hemodynamic criteria.
Mohsen Ziyaeifard, Roghaye Mohammad-Taghi, Rasoul Azarfarin, Reza Abbaszadeh, Mehdi Heidari,
Volume 11, Issue 1 (3-2022)
Abstract
Abstract
Aim. This study aimed to compare the effect of Adaptive Support Ventilation (ASV) and Synchronized Intermittent Mandatory Ventilation-Pressure Support (SIMV-PS) modes on consequence of weaning off patients from mechanical ventilator after coronary artery bypass surgery
Background. The ventilation mode used for respiratory support in patients after coronary artery bypass graft surgery is very important. In addition to avoiding pressure on patient's sternotomy incision, the ventilation mode should also provide the possibility of rapid weaning of patient to avoid complications caused by long-term ventilation.
Method. In a semi-experimental study, 26 patients were ventilated with ASV as the experimental group and 26 patients were ventilated with SIMV-PS mode as the control group after coronary artery bypass graft surgery in Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. Mechanical ventilation time and endotracheal tube removal time, hemodynamic variables, and arterial blood gas analysis were compared between the two groups. Data were analyzed using an independent t-test, repeated measures ANOVA and chi-square.
Findings. Out of 52 patients, 36 (69.2 percent) were male and 16 (30.8 percent) were female. The mean time for the endotracheal tube removal was 89.42±33.83 minutes in the experimental group and 101.53±44.91 minutes in control group, which did not have a statistically significant difference (p=0.843). The mean duration of mechanical ventilation of patients in the experimental group was 483.84±158.153 minutes and in the control group, it was 541.92±257.81 minutes, which were not statistically different (p=0.332).
Conclusion. The use of ASV mode for mechanical ventilation after coronary artery bypass graft did not affect reducing the duration of mechanical ventilation and the time of endotracheal tube removal compared to SIMV-PS mode. Therefore, the use of ASV mode for respiratory support of patients undergoing coronary artery bypass surgery should be considered according to the patient's condition and the nurses' expertise.
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