The Effect of Prone Position Use Ventilator-Associated Pneumonia in Intensive Care Patients

NCT05760716 | Completed

• 1 other identifier: f8c2xi67
• Study Type: observational
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this experimental study was to investigate the effect of prone position use on ventilator values, blood gas and ventilator-associated pneumonia in intensive care unit patients. Between June 2021 and January 2022, 40 trials and 40 control patients were included in the intensive care units of two private hospitals and received mechanical ventilation support. The mechanical ventilator values, arterial blood gases and ventilator-related pneumonia conditions were evaluated and followed for at least 5 to 10 days just before the position was given by comparing the prone position (PP) and the patients were brought back into the supine position. The data were collected using 'Patient Follow-up Charts', 'Clinical Pulmonary Infection Score', 'Braden Pressure Half Risk Assessment' and 'Ramsey Sedation Scale' prepared in line with patient introduction form and evidence-based guidelines. In addition, life findings, cultural results and blood gas analyses were performed. Statistical analysis was performed using the 'NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA)' program. 'Descriptive statistics, parametric and nonparametric tests' were used to evaluate the data. The level of statistical signiation was considered 'p\<0.05'.

Conditions

Intensive Care Unit Syndrome

Keywords

prone position; Intensive care; ventilators mechanical; blood gas; ventilator- associated pneumonia

Outcome Measures

Primary Outcomes (2)

• Patient Information Form

  demographics

  3-5 minutes

• Patient Follow-up Charts

  On vital signs

  15-20 minutes

Secondary Outcomes (3)

• Clinical Pulmonary Infection Score

  3-5 minutes

• Braden Pressure Sore Risk Assessment Scale

  5-8 minutes

• Ramsey Sedation Scale

  5-8 minutes

Study Arms (2)

Experiment Group

* The prone position was positioned within the application steps. * The introductory characteristics form of the patients was filled in on the day the patient was included in the study. * Blood gas results and mechanical ventilator respiration indicators were followed up in the PP for 5-10 days and the changes were recorded in the tolerance hours. Arterial blood gas results, mechanical ventilator values, and ventilator-associated pneumonia status were monitored before the position was applied, during the position and after the patients were placed in the supine position by comparing the groups with and without the prone position. • Nursing intervention application steps for VAP were followed during the PP and the changes were recorded.

Other: practicing prone position

Control Group

Routine nursing care was applied without any intervention. 'Patient Information Form', 'Patient Follow-up Charts', 'Clinical Pulmonary Infection Score', 'Braden Pressure Wound Risk Assessment' and 'Ramsey Sedation Scale' were used.

Interventions

practicing prone position OTHER

Wash your hands. Prepare the materials. Before starting the procedure, inform the patient and explain the procedure. Ensure patient privacy. Raise the guardrail opposite the work area. Take the proper posture. Pay attention to body mechanics. Lay the patient on their back in the middle of the bed. Place a pillow under the patient's head to cover their shoulders. Extend arms to side of body with elbows slightly bent inward (flexion). Place a pillow under your arms. Place roller in palm. Place a thin pillow or a thinly folded towel/sheet under the waist. Place a thin towel under the knees. Support the bottom of the ankles with a pillow. Support the soles of the feet with a foot board. Raise the guardrail on the working side. Inform the patient that they can stay in this position for a maximum of 2 hours.

Experiment Group

Eligibility Criteria

• Age: 18 Years - 90 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The research was carried out between June and December 2021 in the 14-bed and 26-bed general intensive care units of two private hospitals on the European side of Istanbul. Power analysis was performed with the 'G\*Power (v3.1.7) program' in the sample calculation. In general, studies should have 80% power. The power of the study is expressed as '1-β (β = II type error probability)'. Evaluations to be made with two independent groups; Since it is assumed to have a large effect size (d=0.8), according to the calculation made, it was determined that there should be at least 26 people in the groups at the level of 'α=0.05' according to Cohen's effect size coefficients. Considering that there may be losses during the study process, 40 people were included in each group.

You may qualify if:

• Being 18 years or older,
• Receiving respiratory support with a mechanical ventilator in the ICU,
• COVID 19 test negative,
• Consent by the first degree relative.

You may not qualify if:

• Being under the age of 18,
• Receiving a diagnosis of VAP before admission to the ICU,
• Having a positive COVID 19 test,
• Presence of an obstacle to prone positioning (obesity, pregnancy, anterior chest wall surgery, advanced heart failure, etc.).
• Not giving consent to participate in the study by a first-degree relative

Sponsors & Collaborators

• Istanbul Arel University: lead

Study Sites (1)

Istanbul University Cerrahpasa

Istanbul, Turkey (Türkiye)

Location

Related Publications (1)

• Dedeoglu Demir B, Enc N, Borekci S. The effect of prone positioning on ventilator parameters, blood gas levels, and ventilator-associated pneumonia in intensive care unit patients: a randomized controlled trial. BMC Nurs. 2025 Feb 21;24(1):203. doi: 10.1186/s12912-025-02817-3.

  PMID: 39984994 DERIVED

MeSH Terms

Conditions

Pneumonia, Ventilator-Associated

Condition Hierarchy (Ancestors)

Healthcare-Associated Pneumonia; Cross Infection; Infections; Pneumonia; Respiratory Tract Infections; Lung Diseases; Respiratory Tract Diseases; Iatrogenic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: January 10, 2023
• First Posted: March 8, 2023
• Study Start: June 1, 2021
• Primary Completion: July 1, 2022
• Study Completion: November 1, 2022
• Last Updated: March 8, 2023

Record last verified: 2023-03

Locations

TU (1)