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Title: Secretion clearance strategies in Australian and New Zealand Intensive Care Units.
Authors: Hanlon, Gabrielle
Other Authors: Ntoumenopoulos, George
Hammond, Naomi
Watts, Nicola
Thompson, Kelly
Thomas, Peter
George Institute for Global Health and the Australian and New Zealand Intensive Care Society Clinical Trials Group
Keywords: Aspiration Mechanical
Intensive Care Units
Mechanical Ventilation
Physical Therapy Modalities
Respiration Artificial
Secretion Clearance Strategies
Intubated Patients
Mechanically Ventilated Patients
Secretion Clearance Techniques
Chest Wall Vibration
Manual Lung Hyperinflation
Chest Wall Percussion
Postural Drainage
Patient Positioning
Mucus Plugging Events
Patient Outcomes
Intensive Care Unit, Epworth HealthCare, Victoria, Australia.
Issue Date: Jun-2017
Publisher: Elsevier
Citation: Aust Crit Care. 2017 Jun 26. pii: S1036-7314(17)30197-2
Abstract: 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.
DOI: 10.1016/j.aucc.2017.06.002
PubMed URL:
ISSN: 1036-7314
Journal Title: Australian Critical Care
Type: Journal Article
Affiliated Organisations: St Vincent’s Hospital, Sydney, Australia
Discipline of Physiotherapy Graduate School of Health, The University of Technology Sydney, Australia
Critical Care and Trauma Division, The George Institute for Global Health, Australia
Sydney Medical School, University of Sydney, Australia
Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Australia
Menzies Research Institute, Griffith University, Australia
Department of Physiotherapy, Royal Brisbane and Women’s Hospital, Australia
Type of Clinical Study or Trial: Cross-Sectional Study
Appears in Collections:Critical Care

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