Volume 11 Supplement 2

27th International Symposium on Intensive Care and Emergency Medicine

Open Access

Application of treatment bundles reduces days on mechanical ventilation in critically ill patients

  • F Bloos1,
  • S Müller1,
  • A Harz1,
  • M Gugel1,
  • D Geil1,
  • K Reinhart2 and
  • G Marx2
Critical Care200711(Suppl 2):P171

https://doi.org/10.1186/cc5331

Published: 22 March 2007

Background

Reduction of time on the ventilator is a key concept to avoid complications. Recommendations include semirecumbent positioning (SRP) [1], low tidal volume ventilation (TV = 6 ml/kg) [2], prophylaxis for stress ulcer (SUP) [3], and deep vein thrombosis (DVTP) [4]. The goal of this study was to investigate whether staff training about these treatments decreases days on ventilation.

Methods

All patients of a 50-bed ICU with mechanical ventilation >24 hours were included. From June 2005 to September 2005 (Audit I), patients were examined daily for SRP >30°, low tidal volume ventilation, DVTP, and SUP by an independent task force. Afterwards, nurses and physicians were trained for the monitored treatments. Audit II was then performed from March 2006 to June 2006.

Results

One hundred and thirty-three patients (1,389 ventilator-days) were included in Audit I, 141 patients (1,002 ventilator-days) in Audit II. Data are expressed as the median (interquartile range) or percentage of implementation per ventilator-days (Table 1). On average, low tidal volume ventilation was adopted. DVTP and SUP were well implemented without training. There was no effect on frequency of pneumonia, ICU length of stay, or survival.
Table 1

(abstract P171)

 

Audit I

Audit II

P

APACHE II

24 (10)

25 (11)

0.387

SRP (%)

24.9

49.6

<0.001

TV (ml/kg)

6.3 (2.2)

6.4 (2.3)

0.154

DVTP (%)

89.5

91.9

0.048

SUP (%)

94.5

94.9

0.712

Days on ventilation

6.0 (13)

4.0 (7)

0.017

Conclusion

SRP could be successfully improved by staff training. Enhanced implementation was associated with reduction in days on ventilation.

Authors’ Affiliations

(1)
University Hospital Jena
(2)
Friedrich-Schiller University Jena, Friedrich-Schiller University Jena

References

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  3. Cash BD: Crit Care Med. 2002, 30: S373. 10.1097/00003246-200206001-00008PubMedView ArticleGoogle Scholar
  4. Samama MM: N Engl J Med. 1999, 341: 793. 10.1056/NEJM199909093411103PubMedView ArticleGoogle Scholar

Copyright

© BioMed Central Ltd. 2007

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