BACKGROUND: development of ventilator associated pneumonia (VAP) leads to ‎prolonged hospital stay, increased health care cost, and mortality rates. Subglottic ‎secretion drainage through a dedicated endotracheal tube has been advocated as a mean ‎to decrease the incidence of VAP and thereby assisting in ‎the decrease of morbidity associated with invasive mechanical ventilation.‎
OBJECTIVE: Investigate the role of subglottic secretion suctioning in the prevention of VAP in mechanically ventilated patients in intensive care unit.‎
METHODS: A cross sectional study done in the intensive care unit of Ghazi Al-Hariri ‎hospital for surgical specialties in medical city complex, 30 patients who ‎are in need for invasive mechanical ventilation were intubated with endotracheal tube ‎that have special port for subglottic secretion suctioning. Daily monitoring of patients ‎clinical and radiological data to detect features of VAP was ‎done, and if there was a suspicion of pneumonia, culture for tracheal aspirate performed ‎to confirm diagnosis.‎
RESULTS: ‎Patient’s age was 37.1 ± ‎‎15.39 years, the highest proportion of study patients was found in ‎age group < 30 and ‎‎30–49 years (40% in ‎each group), most of the patients were males (70%) with a male to female ratio of ‎‎2.33:1‎‏, ‏Subglottic secretion suctioning lead to reduction in VAP by relative risk (95%CI) of ‏‎0.167 (0.045–0.559)‎‏, p-‏value = 0.001. ‏Twenty eight patients didn’t show any sign, symptoms ‎or radiological features suggesting a ‎diagnosis of pneumonia while two patients developed ‎features of pneumonia (suggestive signs and ‎symptoms, radiological features and ‎positive culture of tracheal aspirate).‎
CONCLUSION: the use of endotracheal tube with subglottic ‎secretions suctioning can have a role in the prevention of VAP in mechanically ventilated patients.‎
Background: Postoperative nausea and vomiting (PONV) is a highly observed feature postoperatively. The type of surgery, the technique, medication, duration of anesthesia, and various patient factors all contribute to the condition.Objectives: To evaluate and compare the effect of halothane and propofol on early postoperative nausea and vomitingPatients and methods: A randomized clinical trial was conducted on 80 patients who scheduled for hernioplasty during the 1st of October/ 2010 to the 5th of February/ 2012 in Baghdad Teaching Hospital / Medical City Complex / Baghdad / Iraq. All patients were allocated into two groups randomly (40 patients each), group(A) were received 1-2 mg/Kg propofol as induction and used for maintenance of anesthesia and group (B) were receive anesthetizing dose of thiopentone 3-5 Mg/Kg, and maintained on halothane. Presence of nausea and vomiting episodes were recorded at 4 time schedule (recovery, 2 hours, 4 hours and 6 hours) postoperatively in both groups.Result: the incidence of nausea and vomiting were more among cases who received halothane, and along the time from recovery to 6 hours post operatively nausea and vomiting were absent in all cases of propofol group.
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