SUBGLOTTIC SECRETION ACCUMULATION AND POSITIONING

Virginia Commonwealth University, Richmond VA

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Abstract

Intubation and mechanical ventilation greatly increase the risk of bacterial pneumonia among mechanically ventilated patients by allowing subglottic secretions to pool above the endotracheal tube cuff and become aspirated: thus, promoting the development of ventilator associated pneumonia (VAP) which has a mortaility rate as high as 55 percent. It is crucial to learn more about the pooling of subglottic secretions and how nurses can positively affect the development of VAP. This relationship is important to understand as it may provide guidance to critical care nurses in assessing suctioning requirements. The specific aims of this study are to: (1) describe the relationship between the volume of subglottic secretions accumulated over time at backrest elevation of 0, 25, and 45 degrees; (2) describe the relationship between the volume of subglottic secretions accumulated over time in lateral positions (right and left); and (3) describe the relationship between sublgottic and oral secretion volume and viscosity.