SEMI RECUMBENT POSITIONING FOR PREVENTING VENTILATOR ASSOCIATED
PNEUMONIA IN ADULTS REQUIRING MECHANICAL VENTILATION
Harris Soetanto1, Gurmeet Singh2
1.Internal Medicine Dept., Universitas Indonesia, Faculty of Medicine. Dr. Cipto Mangunkusumo National General Hospital,
Jakarta, Indonesia.
2.Respirology and Critical Illness Division, Internal Medicine Department, Universitas Indonesia, Faculty of Medicine.
Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Background:
Ventilator associated pneumonia (VAP) is term to describe pneumonia that develops in a patient who has been on mechanical ventilation for more than 48 hours. VAP has been associated with increased mortality, morbidity, length of intensive care unit stay and duration of mechanical ventilation. VAP can be prevented with put patients in a right postion. Based on the literature, semi recumbent positioning has the advantage of convenience and almost no cost to implement. The purpose of this study is to conduct a evidence based case report to date comparing semi recumbent positioning with supine positioning to clarify their current role in the prevention of VAP.
Method: Literature search was performed on the PubMed, Cochrane library, Proquest, Elsevier, and EBSCO. Inclusion criteria of this literature searching was meta analysis, systematic review, and randomized control trial articles, adult requiring mechanical ventilation, compare semi recumbent and supine position. The exclusion criteria was language used other than English or Indonesian
Result: Two meta analysis included in this study. semi recumbent postioning has a significant reduction in clinically suspected VAP and a trend toward a reduction of all cause mortality. Even though, results of this review need to be interpreted cautiously due to the risk of bias.
Conclusion: There is no associated nursing cost in applying semi recumbent position and potential benefit of reducing clinically suspected VAP, so Semi recumbent position (>30o) should be applied if no contraindications are present
Keywords: ventilator associated pneumonia, semi recumbent, supine, mechanically ventilated
