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首页> 外文期刊>Transactions of the Royal Society of Tropical Medicine and Hygiene >Semi-recumbent body position fails to prevent healthcare-associated pneumonia in Vietnamese patients with severe tetanus
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Semi-recumbent body position fails to prevent healthcare-associated pneumonia in Vietnamese patients with severe tetanus

机译：半卧位姿势无法预防越南严重破伤风患者的医疗保健相关性肺炎

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摘要

Healthcare-associated pneumonia (HCAP) is a common complication in patients with severe tetanus. Nursing tetanus patients in a semi-recumbent body position could reduce the incidence of HCAP. In a randomised controlled trial we compared the occurrence of HCAP in patients with severe tetanus nursed in a semi-recumbent (30°) or supine position. A total of 229 adults and children (aged ≥1 year) with severe tetanus admitted to hospital in Vietnam, were randomly assigned to a supine (n = 112) or semi-recumbent (n = 117) position. For patients maintaining their assigned positions and in hospital for > 48. h there was no significant difference between the two groups in the frequency of clinically suspected pneumonia [22/106 (20.8%) vs 26/104 (25.0%); p = 0.464], pneumonia rate/1000 intensive care unit days (13.9 vs 14.6; p = 0.48) and pneumonia rate/1000 ventilated days (39.2 vs 38.1; p = 0.72). Mortality in the supine patients was 11/112 (9.8%) compared with 17/117 (14.5%) in the semi-recumbent patients (p = 0.277). The overall complication rate [57/112 (50.9%) vs 76/117 (65.0%); p = 0.03] and need for tracheostomy [51/112 (45.5%) vs 69/117 (58.9%); p = 0.04) was greater in semi-recumbent patients. Semi-recumbent body positioning did not prevent the occurrence of HCAP in severe tetanus patients. [Clinical Trials.gov Identifier: NCT01331252].
机译：医疗保健相关性肺炎（HCAP）是严重破伤风患者的常见并发症。在半卧位姿势中护理破伤风患者可以降低HCAP的发生率。在一项随机对照试验中，我们比较了半卧位（30°）或仰卧位护理的重度破伤风患者中HCAP的发生率。越南共有229名患有严重破伤风的成人和儿童（≥1岁）入院，被随机分配为仰卧位（n = 112）或半卧位（n = 117）。对于保持其指定位置并且住院时间大于48小时的患者，两组在临床怀疑的肺炎发生频率上没有显着差异[22/106（20.8％）vs 26/104（25.0％）; p = 0.464]，肺炎发生率/ 1000重症监护病房天数（13.9比14.6; p = 0.48）和肺炎发生率/ 1000通气天数（39.2 vs 38.1; p = 0.72）。仰卧位患者的死亡率为11/112（9.8％），而半卧位患者的死亡率为17/117（14.5％）（p = 0.277）。总体并发症发生率[57/112（50.9％）vs 76/117（65.0％）; p = 0.03]，并且需要进行气管切开术[51/112（45.5％）对69/117（58.9％）; p = 0.04）在半卧位患者中更大。在严重的破伤风患者中，半躺式身体姿势不能阻止HCAP的发生。 [Clinical Trials.gov标识符：NCT01331252]。

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