Secretion clearance strategies in Australian and New Zealand Intensive Care Units

Ntoumenopoulos, G; Hammond, N; Watts, NR; Thompson, K; Hanlon, G; Paratz, JD; Thomas, P

Secretion clearance strategies in Australian and New Zealand Intensive Care Units

Ntoumenopoulos, G

Hammond, N Watts, NR Thompson, K Hanlon, G Paratz, JD Thomas, P

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Publication Type:: Journal Article
Citation:: Australian Critical Care, 2018, 31 (4), pp. 191 - 196
Issue Date:: 2018-07-01

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Field	Value	Language
dc.contributor.author	Ntoumenopoulos, G https://orcid.org/0000-0002-1088-3009	en_US
dc.contributor.author	Hammond, N	en_US
dc.contributor.author	Watts, NR	en_US
dc.contributor.author	Thompson, K	en_US
dc.contributor.author	Hanlon, G	en_US
dc.contributor.author	Paratz, JD	en_US
dc.contributor.author	Thomas, P	en_US
dc.date.available	2017-06-15	en_US
dc.date.issued	2018-07-01	en_US
dc.identifier.citation	Australian Critical Care, 2018, 31 (4), pp. 191 - 196	en_US
dc.identifier.issn	1036-7314	en_US
dc.identifier.uri	http://hdl.handle.net/10453/128400
dc.description.abstract	© 2017 Introduction/aims: To describe the processes of care for secretion clearance in adult, intubated and mechanically ventilated patients in Australian and New Zealand Intensive Care Units (ICUs). Methods/results: A prospective, cross-sectional study was conducted through the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) Point Prevalence Program. Forty-seven ICUs collected data from 230 patients intubated and ventilated on the study day. Secretion clearance techniques beyond standard suctioning were used in 84/230 (37%) of patients during the study period. Chest wall vibration 34/84 (40%), manual lung hyperinflation 24/84 (29%), chest wall percussion 20/84 (24%), postural drainage/patient positioning 17/84 (20%) and other techniques including mobilisation 15/84 (18%), were the most common secretion clearance techniques employed. On average (SD), patients received airway suctioning 8.8 (5.0) times during the 24-h study period. Mucus plugging events were infrequent (2.7%). The additional secretion clearance techniques were provided by physiotherapy staff in 24/47 (51%) ICUs and by both nursing and physiotherapy staff in the remaining 23/47 (49%) ICUs. Conclusion: One-third of intubated and ventilated patients received additional secretion clearance techniques. Mucus plugging events were infrequent with these additional secretion clearance approaches. Prospective studies must examine additional secretion clearance practices, prevalence of mucus plugging episodes and impact on patient outcomes.	en_US
dc.relation.ispartof	Australian Critical Care	en_US
dc.relation.isbasedon	10.1016/j.aucc.2017.06.002	en_US
dc.subject.classification	Nursing	en_US
dc.subject.mesh	Mucus	en_US
dc.subject.mesh	Sputum	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Auscultation	en_US
dc.subject.mesh	Drainage, Postural	en_US
dc.subject.mesh	Respiration, Artificial	en_US
dc.subject.mesh	Critical Care	en_US
dc.subject.mesh	Chest Wall Oscillation	en_US
dc.subject.mesh	Suction	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Cross-Sectional Studies	en_US
dc.subject.mesh	Intubation, Intratracheal	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Intensive Care Units	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	New Zealand	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Physical Therapy Modalities	en_US
dc.subject.mesh	Patient Positioning	en_US
dc.title	Secretion clearance strategies in Australian and New Zealand Intensive Care Units	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	31	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	31	en_US

Abstract:

© 2017 Introduction/aims: To describe the processes of care for secretion clearance in adult, intubated and mechanically ventilated patients in Australian and New Zealand Intensive Care Units (ICUs). Methods/results: A prospective, cross-sectional study was conducted through the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) Point Prevalence Program. Forty-seven ICUs collected data from 230 patients intubated and ventilated on the study day. Secretion clearance techniques beyond standard suctioning were used in 84/230 (37%) of patients during the study period. Chest wall vibration 34/84 (40%), manual lung hyperinflation 24/84 (29%), chest wall percussion 20/84 (24%), postural drainage/patient positioning 17/84 (20%) and other techniques including mobilisation 15/84 (18%), were the most common secretion clearance techniques employed. On average (SD), patients received airway suctioning 8.8 (5.0) times during the 24-h study period. Mucus plugging events were infrequent (2.7%). The additional secretion clearance techniques were provided by physiotherapy staff in 24/47 (51%) ICUs and by both nursing and physiotherapy staff in the remaining 23/47 (49%) ICUs. Conclusion: One-third of intubated and ventilated patients received additional secretion clearance techniques. Mucus plugging events were infrequent with these additional secretion clearance approaches. Prospective studies must examine additional secretion clearance practices, prevalence of mucus plugging episodes and impact on patient outcomes.

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http://hdl.handle.net/10453/128400