Treatise
Effect of prone position management on preventing ventilator-associated pneumonia in children with congenital heart disease complicated with acute respiratory distress syndrome
Wu Yibei, Chen Lin, Luo Wenyi, Bao Rui
Published 2023-08-21
Cite as Chin J Prac Nurs, 2023, 39(24): 1853-1858. DOI: 10.3760/cma.j.cn211501-20220620-01935
Abstract
ObjectiveTo develop a prone position management program and evaluate its effectiveness in preventing ventilator-associated pneumonia (VAP) in children with congenital heart disease combined with acute respiratory distress syndrome, in order to provide experience for clinical application.
MethodsThis was a quasi-experimental study. Convenient sampling method was used to select children with congenital heart defect who underwent mechanical ventilation in the Cardiothoracic Surgical Care Unit of Shanghai Children′s Medical Center, Shanghai Jiao Tong University, School of Medicine from June 2018 to December 2021 as the study subjects. The control group consisted of 80 hospitalized children from June 2018 to December 2019. They were used general nursing interventions to prevent VAP. The 42 hospitalized children from January 2020 to December 2021 were the intervention group, who usd the prone position management program on the basis of the control group. The differences in the incidence of VAP, duration of mechanical ventilation, duration of ICU stay, oxygenation index and the incidence of adverse events between the two groups were compared.
ResultsThe incidence of VAP and mechanical ventilation duration in the intervention group were 4.8% (2/42) and 67.50 (55.00/101.50), which were lower than 35.0% (28/80) and 92.50 (68.00/142.00) of the control group, and the differences were statistically significant (χ2=11.98, Z=3.40, both P<0.01). And the trend of increasing oxygenation index with the intervention group was better than the control group (F=8.38, P<0.05). There was no statistical difference in the incidence of adverse events between the two groups (all P>0.05).
ConclusionsThe application of prone ventilation program with congenital heart disease children complicated with acute respiratory distress syndrome is safe and can significantly improve the oxygenation index, shorten the duration of mechanical ventilation and reduce the incidence of VAP.
Key words:
Ventilator-associated pneumonia; Congenital heart disease; Prone position
Contributor Information
Wu Yibei
Department of Cardiovascular Intensive Care Unit, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Chen Lin
Department of Cardiovascular Intensive Care Unit, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Luo Wenyi
Department of Nursing, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Bao Rui
Department of Cardiovascular Intensive Care Unit, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China