Effects of Various Degrees of Semi-Recumbent Positioning in Prevention of Ventilator-Associated Pneumonia

Abstract

Ventilator-associated pneumonia (VAP) is one of the common complications occurring in patients predominantly in intensive care units. It is a respiratory tract infection that develops in patients who are intubated for more than 48 hours to 72 hours. It is commonly caused by pseudomonas aeruginosa, If the infection occurs within the first 48 to 72 hours, it is called “earlyonset” and if after 72 hours is termed as “late-onset”1. Even though there are innumerable methods to decrease the infection and its associated morbidity we wanted to examine whether any changes in position were effective in its reduction. The experimental study was conducted on 30 samples collected in a consecutive manner. The study was performed in the Intensive care unit of a medical college hospital for a period of 2 months. The study included both male and female patients between 18 – 55 years who underwent mechanical ventilation for >48 hrs. Following inclusion criteria, patients were screened and randomly divided into 3 equal groups, Group A (35-degree recumbency), Group B (40-degree recumbency), and Group C (45-degree recumbency). The degree was measured by a protractor which was confirmed with available protractor software. The pre and the post (Clinical Pulmonary Infection Scores) CPIS scores were noted. The demographic variables were similar between the groups. There was a significant reduction of scores in Group B and C than A (p value <0.001) there were no major side effects. There were no dropouts. We conclude that both 40-degree and 45-degree recumbency significantly decrease CPIS scores than 35 degrees. Even though Group C is better than group B it’s statistically insignificant.