Semi-recumbent body position fails to prevent healthcare-associated pneumonia in Vietnamese patients with severe tetanus
| Autor: | Tran Thi Thuy, Louise Thwaites, Nguyen Thien Binh, James Campbell, Nguyen Minh Duong, Jeremy Farrar, Nguyen Thi Ngoc Nga, Christopher M. Parry, Huynh Thi Loan, Janet Parry, Lam Minh Yen |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
Pediatrics Supine position Semi-recumbent law.invention 0302 clinical medicine Tracheostomy Randomized controlled trial law 030212 general & internal medicine Treatment Failure Child Cross Infection Tetanus Incidence (epidemiology) Incidence Body position General Medicine Middle Aged Intensive care unit 3. Good health Healthcare-associated pneumonia Intensive Care Units Infectious Diseases Vietnam Child Preschool Female Adult medicine.medical_specialty Randomization Adolescent 030231 tropical medicine Article Patient Positioning 03 medical and health sciences Young Adult Internal medicine medicine Humans Aged business.industry Public Health Environmental and Occupational Health Infant Pneumonia medicine.disease Respiration Artificial Parasitology business Complication |
| Zdroj: | Transactions of the Royal Society of Tropical Medicine and Hygiene |
| ISSN: | 1878-3503 0035-9203 |
| Popis: | Healthcare-associated pneumonia (HCAP) is a common complication in patients with severe tetanus. Nursing tetanus patients in a semi-recumbent body position could reduce the incidence of HCAP. In a randomised controlled trial we compared the occurrence of HCAP in patients with severe tetanus nursed in a semi-recumbent (30°) or supine position. A total of 229 adults and children (aged ≥1 year) with severe tetanus admitted to hospital in Vietnam, were randomly assigned to a supine (n = 112) or semi-recumbent (n = 117) position. For patients maintaining their assigned positions and in hospital for > 48. h there was no significant difference between the two groups in the frequency of clinically suspected pneumonia [22/106 (20.8%) vs 26/104 (25.0%); p = 0.464], pneumonia rate/1000 intensive care unit days (13.9 vs 14.6; p = 0.48) and pneumonia rate/1000 ventilated days (39.2 vs 38.1; p = 0.72). Mortality in the supine patients was 11/112 (9.8%) compared with 17/117 (14.5%) in the semi-recumbent patients (p = 0.277). The overall complication rate [57/112 (50.9%) vs 76/117 (65.0%); p = 0.03] and need for tracheostomy [51/112 (45.5%) vs 69/117 (58.9%); p = 0.04) was greater in semi-recumbent patients. Semi-recumbent body positioning did not prevent the occurrence of HCAP in severe tetanus patients. [Clinical Trials.gov Identifier: NCT01331252]. © 2011 Royal Society of Tropical Medicine and Hygiene. |
| Databáze: | OpenAIRE |
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