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Assessment of Pulmonary Aspiration among Intensive Care Patients Having Enteral Feeding by Using Nasogastric Tube

تقييم حدوث الاستنشاق الرئوي لدى مرضى العناية الحرجة الموضوع لهم التغذية المعوية بالانبوب الأنفي المعدي

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 Publication date 2023
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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Enteral feeding is preferred route of nutrition support in critically ill adults when GIT function is good. Enteral nutrition is recommended method to be used when oral feeding fails, so the nutrition is delivered through a tube inserted into the stomach. Enteral nutrition has some complications; Mechanical complications are represented by pulmonary aspiration. Pulmonary aspiration is defined as inhalation of the contents of the mouth, pharynx or stomach into the respiratory tract. So it's important to evaluate pulmonary aspiration occurrence, this may help in prevention care. This study aimed to evaluate pulmonary aspiration among critically ill patients who have Enteral feeding by using nasogastric tube. Descriptive study was performed using convenience sample of (n=15) patients at intensive care unit in tishreen university hospital in lattakia, Syria. Data were collected during the period of 16/2 to 16/5 2022. A structured questionnaire used in the study was developed by researcher, this tool was tested for reliability and validity, a pilot study was done for 3 nurses to test the tool applicability. This study results show the presence blue colure (which added to feeding meal) in the aspirated secretion in the first day at the third suction trial. This study recommended applying an evidenced based practice written protocol about enteral feeding in ICU, to decrease the incidence of pulmonary aspiration.


Artificial intelligence review:
Research summary
تعتبر التغذية المعوية باستخدام الأنبوب الأنفي المعدي الطريقة المفضلة لتغذية المرضى في وحدات العناية المركزة عندما تكون وظيفة الجهاز الهضمي سليمة. تهدف هذه الدراسة إلى تقييم حدوث الاستنشاق الرئوي بين المرضى الذين يتلقون التغذية المعوية باستخدام الأنبوب الأنفي المعدي في وحدة العناية المركزة بمستشفى تشرين الجامعي في اللاذقية، سوريا. تم إجراء الدراسة على عينة مكونة من 15 مريضًا باستخدام استبيان مطور من قبل الباحث. أظهرت النتائج وجود علامات الاستنشاق الرئوي في اليوم الأول من التقييم، وأوصت الدراسة بتطبيق بروتوكول مكتوب يعتمد على الأدلة العلمية لتقليل حدوث الاستنشاق الرئوي وتقييم المرضى بشكل دوري للكشف المبكر عن علامات الاستنشاق.
Critical review
تعتبر هذه الدراسة خطوة مهمة في تقييم حدوث الاستنشاق الرئوي بين المرضى في وحدات العناية المركزة، إلا أن هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير جدًا (15 مريضًا فقط)، مما قد يحد من تعميم النتائج على مجموعات أكبر. ثانياً، لم يتم توضيح كيفية اختيار العينة بشكل كافٍ، مما قد يؤثر على تمثيلية العينة. ثالثاً، كان من الممكن استخدام تقنيات أكثر تقدمًا لقياس حدوث الاستنشاق الرئوي بدلاً من الاعتماد فقط على ملاحظة اللون الأزرق في المفرزات. وأخيرًا، كان من الأفضل تضمين توصيات محددة حول كيفية تدريب الكادر التمريضي على تطبيق البروتوكول المقترح.
Questions related to the research
  1. ما هو الهدف الرئيسي من هذه الدراسة؟

    الهدف الرئيسي من هذه الدراسة هو تقييم حدوث الاستنشاق الرئوي بين المرضى الذين يتلقون التغذية المعوية باستخدام الأنبوب الأنفي المعدي في وحدة العناية المركزة.

  2. ما هي الأداة المستخدمة لجمع البيانات في هذه الدراسة؟

    تم استخدام استبيان مطور من قبل الباحث لجمع البيانات في هذه الدراسة.

  3. ما هي التوصية الرئيسية التي خرجت بها الدراسة؟

    أوصت الدراسة بتطبيق بروتوكول مكتوب يعتمد على الأدلة العلمية لتقليل حدوث الاستنشاق الرئوي وتقييم المرضى بشكل دوري للكشف المبكر عن علامات الاستنشاق.

  4. ما هي بعض العوامل التي قد تؤدي إلى حدوث الاستنشاق الرئوي لدى المرضى؟

    بعض العوامل التي قد تؤدي إلى حدوث الاستنشاق الرئوي تشمل انخفاض مستوى الوعي، تغير حركية الجهاز الهضمي، بطء إفراغ المعدة، ووجود الطرق التنفسية الاصطناعية.


References used
PAOLO G, TWOMLOW E, HANNA F, FARMER A, LANCASTER J, ROFFE C.. Continuous or Intermittent? Which Regimen of Enteral Nutrition is Better for Acute Stroke Patients in ICU? . On J Neur & Br Disord (2019); 7(7): 247-255.
COMPHER C, JOSEPH I, CAROL L, DRUYAN M. Clinical Guidelines for the Use ofParenteral and Enteral Nutrition in Adult and Pediatric Patients. Journal ofParenteral and Enteral Nutrition (2009) ;33(3): 255-259
LIN Y, SUN Z, WANG H, LIU M. The effects of gastrointestinal function on theincidence of ventilator-associated pneumonia in critically ill patients. Open Med; (2018). 13: 556-561
SELIMAN A, EL-SOUSSI A, SULTANM, OTHMAN S. Effect of Implementing Nursing Guidelines for Tube Feeding on the Occurrence of Aspiration among Critically Ill Patients. Nature and Science (2011); 9(11): 164-170.
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Patients in the intensive care unit (ICU), especially ventilated patients, are at considerable risk of developing ocular surface disease because the protective eye mechanisms are damage, as decrease eyelid closure ,unable blinking, decreased produc ing tears, increased expose the eye to pathogen bacteria . These factors often result in incomplete lid closure and expose and decay the eye, and this called the exposure keratopathy, which appear that high rate with ventilated patients. The eye care is a part of the providing care to every patient in critical care units. Whereas the Unconscious and Sedation and paralysis patients are the most serious group and the most need to the eye care for maintain the eye in a state of normal.objective:To determine the effect kind of eye care policy on incidence rate of exposure keratopathyamong mechanically ventilated patients.
The installation and care of urinary catheters is one of the tasks entrusted to nursing personnel, as the urinary tract is a passageway for the excretion of many hazardous wastes that are excreted with urine. Unfortunately, in some cases, the surviva l of this duct may require the installation of a urinary catheter. This procedure usually weakens the defenses of the natural urethra, and in some cases this may cause dangerous infections that may reach the kidneys; Accordingly, the nursing staff must work to relieve the discomfort associated with the urinary catheter; By performing this procedure according to the approved steps and protocols, this study aimed to identify the level of knowledge and performance of the nursing staff about the nursing care of patients with urinary catheterization among 46 nurses, who were selected by the convenient sample method. The data were collected using a questionnaire developed by the researcher himself. Where the study showed that 93.5% of the participants had a good level of correct information, and that 6.5% of them had a moderate level of correct information. The performance of 95.7% of them was good before starting the catheter installation, and during the installation the performance of 82.6% of them was good, while after the completion of the installation 89.1% of them performed well. The study recommended the development of a written protocol related to urinary catheter insertion and its indications to be implemented and patient education about it, and regular and continuous updating of evidence-based guidelines for nursing procedures.
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