Russian multicenter observational clinical study “Register of respiratory therapy for patients with stroke (RETAS)”: infectious complications of mechanical ventilation

Ершов, В. И.; Belkin, Andrey; Горбачев, В.И.; Грицан, А.И.; Zabolotskikh, I.B.; Лебединский, К.М.; Лейдерман, И. Н.; Петриков, С. С.; Protsenko, D.N.; Солодов, А. А.; Щеголев, А. В.; Tikhomirova, A.A.; Khodchenko, V.V.; Mescheryakov, A.O.; Silkin, V.V.

doi:10.17116/anaesthesiology202301119

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…Because of the aspiration risk, there is a high risk of the development of malnutrition in patients. Catabolism is activated by malnutrition, and this is among the factors increasing the risk of pneumonia 6 . Assessment of dysphagia is important to reduce the risk of aspiration.…”

Section: Introductionmentioning

confidence: 99%

“…Catabolism is activated by malnutrition, and this is among the factors increasing the risk of pneumonia. 6 Assessment of dysphagia is important to reduce the risk of aspiration. Dysphagia assessment procedures are selected according to patient characteristics, the seriousness of the swallowing disorder, and the appropriateness of the procedure.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of aspiration risk by relatives of inpatients in the neurology service: A metaphor analysis

Kaş,

Çakır,

Kocatürk

2023

Health Expectations

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BackgroundThe risk of aspiration is high in stroke patients due to dysphagia/loss of swallowing. This problem can cause problems affecting the nutrition of patients. Due to the possible risk of aspiration during feeding, patient relatives are hesitant to feed their patients. Because of this fear, malnutrition and hospital readmissions may increase. It is important to evaluate the fear of aspiration risk of relatives of patients hospitalized in the neurology service. The aim of this study is to determine the views of the relatives of patients treated in the neurology service about the risk of aspiration through metaphors.MethodThis article analyzed metaphors of patients' relatives' about the risk of aspiration. The analysis uses metaphor identification and analysis. The research sample consisted of 31 patients. First of all, in the study, evaluation of the data was conducted by performing content analysis, as a result of which it was divided into metaphors and conceptual categories, and the relevant field was associated with the text (event, thought, feelings, related in speech or writing). In the reporting of research, the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used.ResultsIt was seen that the patients' relatives produced 31 different metaphors in response to the statement ‘Aspiration risk is like …, because it is …’ The patients' relatives mostly compared the concept of ‘fear of aspiration’ to the concept of ‘fear’ (n: 24).ConclusionsIn this study, relatives mostly described the concept of fear related to the risk of aspiration. According to this result, patients' relatives have a great fear of aspiration increasing the risk of readmission to hospital and of malnutrition. This result shows that informing patients' relatives will increase awareness and will allow them to provide informed care.Patient and Public ContributionCollaborated with patients and their relatives regarding the risk of aspiration and contributed to the planning of care for the risk of aspiration.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of aspiration risk by relatives of inpatients in the neurology service: A metaphor analysis

Kaş,

Çakır,

Kocatürk

2023

Health Expectations

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Risk Factors for the Development and Severe Course of Ventilator-Associated Tracheobronchitis in Patients with Prolonged Mechanical Ventilation

Ibadov,

Sabirov,

Eshonkhodjaev

et al. 2023

Obŝaâ reanimatologiâ

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Objective. Identification of risk factors for the development and severe course of ventilator-associated tracheobronchitis (VAT) in patients on prolonged mechanical ventilation (PMV).Methods. VAT incidence rate in the intensive care unit of Academician V. Vakhidov Republican Scientific and Practical Medical Center for Surgery for the period 2018-2022 was evaluated retrospectively in 724 patients who were on PMV (more than 48 hours). Patients’ clinical and demographic characteristics were subjected to factor analysis. Mean age was 52.4±3.3 (18-81) years. VAT was diagnosed based on clinical signs (fever >38°C, leukocytosis > 12 000 ctlls/ml, or leukopenia <4 000 cells/ml, purulent endotracheal secretions, or conversion to purulent), radiological (no progression of existing or emergence of new pulmonary infiltrates) and microbiological (polymorphonuclear lymphocytes with or without bacteria, moderate-to active growth of colonies of potentially pathogenic microorganisms) criteria. VAT prophylaxis was based on the use of bacterial filters and humidification of the respiratory gas; selective decontamination of the digestive tract; regulation of pressure in the tracheal cuff; sanitation of the oral cavity. Treatment of VAT included antimicrobial drugs administered i/v and/or inhalational, bronchodilators, expectorants and mucolytics.Results. VAT incidence rate decreased over time from 24.7% to 10.1% (χ2=9.52; p=0.003) with invariable practice of ventilator support. The incidence of the most severe VAT (hemorrhagic catarrhal purulent) also gradually decreased from 44.7% to 14.3% (χ2=4.53; p=0.034).The duration of PMV and ICU stay in patients with VAT gradually decreased from 202.1±6.15 hours to 125.3±7.81 hours (t=7.73; p<0.0001), and from 9.7±0.25 days to 6.6±0.3 days (t=7.94; p<0.0001), respectively. In patients with VAT (n=122), in contrast to patients without VAT (n=602), the incidence of concomitant COPD was higher – 22.9% vs 10.6%, respectively (p<0.001). Gram-negative flora was the leading cause for development of severe tracheobronchitis, including Acinetobacter spp. - in 24% of cases, Klebsiella pneumoniae – in 11.6%, Pseudomonas aeruginosa – in 13.0%, Esherichia coli – 10.6%. Less frequently were isolated Staphylococcus aureus – in 5.3%, Enterococcus spp. – in 2.2% and Candida fungi– in 17.0%. The following predictors of severe VAT were identified: age over 60 years (OR=2.28; 95% CI 1.0-4.9), SAPS II > 40 scores (OR=5.9; 95% CI 2.6-13.8), duration of mechanical ventilation > 144 hours (OR=5.4; 95% CI 1.8-16.7) and the presence of malignant neoplasms (OR=2.83; 95% CI 1.2-6.9).Conclusion. Decrease in VAT incidence rates, reduced duration of mechanical ventilation and ICU stay are indicative of adequate VAT prevention and treatment strategies within the analyzed period. Factors associated with VAT development and predictors of severe VAT can be used for identification of high risk patients.

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Prevention of nosocomial pneumonia recurrence using a bacteriophage cocktail in intensive care unit

Grechko,

Gurkova,

Zhdanova

et al. 2024

Rus. J. Anes. Reanim.

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Russian multicenter observational clinical study “Register of respiratory therapy for patients with stroke (RETAS)”: infectious complications of mechanical ventilation

Cited by 5 publications

References 16 publications

Evaluation of aspiration risk by relatives of inpatients in the neurology service: A metaphor analysis

Evaluation of aspiration risk by relatives of inpatients in the neurology service: A metaphor analysis

Risk Factors for the Development and Severe Course of Ventilator-Associated Tracheobronchitis in Patients with Prolonged Mechanical Ventilation

Prevention of nosocomial pneumonia recurrence using a bacteriophage cocktail in intensive care unit

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