The effect of a designed Care Plan on the incidence of aspiration in intubated patients: A randomized clinical trial

Background : Patients hospitalized in intensive care unit are at risk of aspiration and subsequent complications due to factors such as endotracheal tube, mechanical ventilation, and decreased level of consciousness. Aspiration of gastric residuals to the lung is one of the preventable lesions in patients who are feeding by tube and under mechanical ventilation.This study was conducted to determine the effect of designed care Plan on incidence of aspiration in intubated patients in ICU. Methods: In this clinical trial, the study population included intubated and mechanically ventilated patients who hospitalized in two ICUs of educational hospitals in 2016. Seventy eligible patients were randomly allocated through permuted blocks into two groups of 35 each. A designed care Plan consisting of head of bed elevation, abdominal massage, measurement of gastric residual volumes was implemented for 3 days in the morning and evening in intervention group, while the control group only received routine care. PH-metric process was used to test oral secretions to diagnose aspiration of gastric residuals. Data were analyzed using independent T-test and chi-square by SPSS 15. Findings: Before the intervention, aspiration occurred in all patients in both intervention and control groups. On the second day of study, (7.1%) in intervention group and 92.9% in control group were inflicted by aspiration. During third day of study, 100% of control group suffered from aspiration while aspiration did not occur in any patient of intervention group (p<0.0001). Conclusions: Implementation of a designed care plan including bed elevation, abdominal massage and gastric residual volume measurement had reduced the incidence of aspiration in intubated patients in the ICU, so planning for regular implementation of these preventive programs should be considered in patient care.