The Effect of Close Suction to Prevent Ventilator-Associated Pneumonia Based on the Sequence Organ Failure Assessment Score (Sofa) and Clinical Pulmonary Infection Score
Abstract
The purpose of the study is to compare SOFA Score and CPIS by using close suction to prevent VAP. This is a quasi-experiment study without a control group. Close suction is used as an intervention. SOFA score and CIPS were used to evaluate VAP. The SOFA score assesses respiratory, platelet, liver, neurology, cardiovascular, and renal function. SOFA scores range from 0 to 24 and if the mean score ≥ 6 indicates the functioning organ is worse. CPIS evaluates body temperature, leucosis, sputum secretion, thorax photo, culture endotracheal secretion, and oxygen saturation. The CPIS score ranges from 0-12, more than 6 indicates the patient has VAP. This study included 20 ICU patients on ventilators. The collected data were analyzed using percentages, mean, and paired t-tests. The mean SOFA score before and after was 4.75 to 4.1 and CPIS 2.9 to 2.65 before and after providing close suction. The close suction is significant to prevent VAP (p-value < 0.00). Close suction is effective to prevent VAP in patients with ventilator mechanics, and VAP can be measured using the SOFA score and CPIS.
Keywords: close suction, CPIS, mechanic ventilator, ventilator-associated pneumonia, SOFA
References
[1] Holly Keyt, Faverio P, Restrepo MI. Prevention of ventilator-associated pneumonia in the intensive care unit: A review of the clinically. Indian J Med Res. 139:814-821.
[2] Hellyer TP, Ewan V, Wilson P, Simpson AJ. The Intensive Care Society recommended bundle of interventions for the prevention of ventilator-associated pneumonia. J Intensive Care Soc. 2016;17(3):238-243. https://doi.org/10.1177/1751143716644461
[3] Rello J, Riera J, Serrano R. What’s new in ventilator-associated pneumonia? Intensive Care Med. 2015;41(11):1954-1956. https://doi.org/10.1007/s00134-015-3909-8
[4] Kalanuria AA, Marek Mirski WZ. Ventilator-associated pneum. Crit Care. 2014;18(208).
[5] Klompas M. Ventilator-associated events 5 years later. Respir Care. 2017;62(11):1501- 1503. https://doi.org/10.4187/respcare.05890
[6] Gomes GF, Pisani JC, Macedo ED, Campos AC. The nasogastric feeding tube as a risk factor for aspiration and aspiration pneumonia. Curr Opin Clin Nutr Metab Care. 2003;6(3):327-333. https://doi.org/10.1097/01.mco.0000068970.34812.8b
[7] Boltey E, Yakusheva O, Costa DK. 5 Nursing strategies to prevent ventilatorassociated pneumonia. Am Nurse Today. 2017;12(6):42–43.
[8] Nency C, Irawan D, Andrini F. Gambaran Kejadian Ventilator-Associated Pneumonia Pada Pasien Yang Dirawat Di Icu Dan Cvcu Rsud Arifin Achmad. Jom FK. 2015;2(2).
[9] Ministry Health of Indonesia. Pedoman Pencegahan dan Pengendalian Infeksi di FASYANKES. 2017. Retrieved from http://hukor.kemkes.go.id/uploads/produk_hukum/PMK_No. _27_ttg_Pedoman_Pencegahan_dan_Pengendalian_Infeksi_di_FASYANKES_.pdf
[10] Siti Rahmalia Hairani D, Utami GT, Nurcahyati S, Safri. Organ failure of patients using ventilator based on the sequence organ failure assessment score (SOFA) admitted in Intensive Care Unit. Enfermería Clínica. 2019;29:5-8. https://doi.org/10.1016/j.enfcli.2019.01.001
[11] Selma Basyigit. Clinical pulmonary infection score (CPIS) as a screening tool in ventilatory associated pneumonia (VAP).The Medical Bulletin of Sisli Etfal Hospital. 2017;51(2).
[12] Chiwhane A, Diwan S. Characteristics, the outcome of patients on invasive mechanical ventilation: A single-center experience from central India. Egypt J Crit Care Med. 2016;(4):113-118.
[13] Tirovoipati R, Chiezey B, Lewis D. Stress hyperglycemia may not be harmful in critically ill patients with sepsis. J Crit Care. 2012;27:153-158.
[14] Basyigit S. Clinical pulmonary infection score (CPIS) as a screening tool in ventilatory associated pneumonia (VAP). Retrieved from:i https://www.journalagent.com/sislietfaltip/pdfs/SETB_51_2_133_141%5BA%5D.pdf pada tanggal 8 September 2019.
[15] Atul AK, Wendy Z, Marek M. Ventilator-associated pneumonia in the ICU. Crit Care. 2014;18:208.
[16] Aryani DF, Tanner J. Does open or closed endotracheal suction affect the incidence of ventilator-associated pneumonia in the intensive care unit? A systematic review. Enfemeria Clinica. 28(S1):325-331.
[17] Dehghani A, Davaridolatabadi E, Abde Yazdan G. Comparison of SOFA and APACHEII scores in predicting weaning of patients from ventilator in the ICU Ward of Amin Hospital in Isfahan, Iran. Int J Med Res Health Sci. 2016;5(9):128-136.
[18] Napolitano LM. Use of severity scoring and stratification factors in clinical trials of hospital-acquired and ventilator associated pneumonia.
[19] Madan HK, Singh R, Karnik ND. Value of SOFA scores in predicting prognosis in patients with ventilator-associated pneumonia. Int J Anat Radiol Surg. 2016;5(3):1-6.
[20] Faradita Aryani D, Tanner J. Does open or closed endotracheal suction affect the incidence of ventilator associated pneumonia in the intensive care unit? A systematic review. Enfermería Clínica. 2018;28:325-331. https://doi.org/10.1016/s1130- 8621(18)30179-7