Cited by 1,243Nosocomial Infections in ICUIntensive Care Unit Cognitive DisordersRespiratory Support and Mechanisms

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Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised trial

Drakulovic, Mitra B, Torres, Antoni, Bauer, Torsten T, Nicolas, Jose M, Nogué, Santiago, Ferrer, Miquel·1999·The Lancet

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Abstract

Background Risk factors for nosocomial pneumonia, such as gastro-oesophageal reflux and subsequent aspiration, can be reduced by semirecumbent body position in intensive-care patients. The objective of this study was to assess whether the incidence of nosocomial pneumonia can also be reduced by this measure.Methods This trial was stopped after the planned interim analysis. 86 intubated and mechanically ventilated patients of one medical and one respiratory intensive-care unit at a tertiary-care university hospital were randomly assigned to semirecumbent (n=39) or supine (n=47) body position. The frequency of clinically suspected and microbiologically confirmed nosocomial pneumonia (clinical plus quantitative bacteriological criteria) was assessed in both groups. Body position was analysed together with known risk factors for nosocomial pneumonia.Findings The frequency of clinically suspected nosocomial pneumonia was lower in the semirecumbent group than in the supine group (three of 39 [8%] vs 16 of 47 [34%]; 95% CI for difference 10.0-42.0, p=0.003). This was also true for microbiologically confirmed pneumonia (semirecumbent 2/39 [5%] vs supine 11/47 [23%]; 4.2-31.8, p=0.018). Supine body position (odds ratio 6.8 [1.7-26.7], p=0.006) and enteral nutrition (5.7 [1.5-22.8], p=0.013) were independent risk factors for nosocomial pneumonia and the frequency was highest for patients receiving enteral nutrition in the supine body position (14/28, 50%). Mechanical ventilation for 7 days or more (10.9 [3.0-40.4], p=0.001) and a Glasgow coma scale score of less than 9 were additional risk factors.Interpretation The semirecumbent body position reduces frequency and risk of nosocomial pneumonia, especially in patients who receive enteral nutrition. The risk of nosocomial pneumonia is increased by long-duration mechanical ventilation and decreased consciousness.

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Controlled Sedation with Alphaxalone-Alphadolone
Ramsay, M. A. E., Savege, T. M., Simpson, B. R. J., & Goodwin, R. (1974) · BMJ · doi:10.1136/bmj.2.5920.656 · Cited by 2,860
The Prevalence of Nosocomial Infection in Intensive Care Units in Europe
Vincent, J. (1995) · JAMA · doi:10.1001/jama.274.8.639 · Cited by 2,592
The Risk of Determining Risk with Multivariable Models
Concato, J., Feinstein, A. R., & Holford, T. R. (1993) · Annals of Internal Medicine · doi:10.7326/0003-4819-118-3-199302010-00009 · Cited by 1,129
State- and sex-specific prevalence of selected characteristics--Behavioral Risk Factor Surveillance System, 1996 and 1997.
Holtzman, D. J., Powell‐Griner, E., Bolen, J. C., & Rhodes, L. (2000) · PubMed · Cited by 1,110
Nosocomial Pneumonia in Patients Receiving Continuous Mechanical Ventilation: Prospective Analysis of 52 Episodes with Use of a Protected Specimen Brush and Quantitative Culture Techniques
Fagon, J.-Y., Chastre, J. E., Domart, Y., Trouillet, J., Pierre, J., Darne, C., & Gibert, C. (1989) · American Review of Respiratory Disease · doi:10.1164/ajrccm/139.4.877 · Cited by 819
Ventilator-Associated Pneumonia
Kollef, M. H. (1993) · JAMA · doi:10.1001/jama.270.16.1965 · Cited by 727
A Comparison of Sucralfate and Ranitidine for the Prevention of Upper Gastrointestinal Bleeding in Patients Requiring Mechanical Ventilation
Cook, D., Guyatt, G. H., Marshall, J., Leasa, D. J., Fuller, H. D., Hall, R., Peters, S., Rutledge, F. S., Griffith, L. E., McLellan, A., et al. (1998) · New England Journal of Medicine · doi:10.1056/nejm199803193381203 · Cited by 726
Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position
Torres, A., Serra-Batlles, J., Ros, E., Piera, C., de la Bellacasa, J. P., Cobos, A., Lomeña, F., & Rodríguez-Roisin, R. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-116-7-540 · Cited by 721
Nosocomial Pneumonia
Celis, R., Torres, A., Gatell, J. M., Almela, M., Rodriguez‐Roisin, R., & Agustí-Vidal, A. (1988) · CHEST Journal · doi:10.1378/chest.93.2.318 · Cited by 685
Guideline for Prevention of Nosocomial Pneumonia
Tablan, O. C., Anderson, L. J., Arden, N. H., Breiman, R. F., Butler, J. C., & McNeil, M. M. (1994) · Infection Control and Hospital Epidemiology · doi:10.1086/646989 · Cited by 578

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Background
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Semirecumbent position in intensive care patients
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Background
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“Data are confl icting as to whether gastroesophageal refl ux may occur more frequently when a feeding tube is used in supine position [ 71 , 72 ].”
Background
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1. Rapp RP, Young DB, Twyman D. The favorable effect of early parenteral feeding on survival in head-injured patients. J Neurosurgery 1983;58:906-12 Pubmed Link 2. Adams S, Dellinger EP, Wertz MJ. Enteral versus parenteral nutritional support following laparotomy for trauma: A randomized prospective trial. J Trauma 1986;26(10):882-891.
Link, P., Ee, M., Jones, T. N., & Fa, M. (2009) · Cited by 3
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Background
Reducción de incidencia de neumonía asociada a ventilación mecánica post cirugía cardíaca: experiencia de 13 años de vigilancia epidemiológica en un hospital universitario
Ajenjo, M. C., Zambrano, A., Eugenin, M. I., Achurra, P., Ricardo Zalaquett, S., Irarrázaval, M. J., de la Cerda, G., Fernández, P. C., Barañao, M., Fuentealba, P., et al. (2013) · Revista chilena de infectología · doi:10.4067/s0716-10182013000200002 · Cited by 2
Pneumopathies nosocomiales acquises sous ventilation mécanique
Donati, S. Y., & Papazian, L. (2008) · EMC-Anesthésie réanimation/Encyclopédie médico-chirurgicale. Anesthésie, réanimation · doi:10.1016/s0246-0289(08)44776-x · Cited by 2
Prise en charge des patients obèses en réanimation: aspects techniques
Clec’h, C., Gonzalez, F., & Cohen, Y. (2006) · Réanimation · doi:10.1016/j.reaurg.2006.09.010 · Cited by 2
Soporte nutricional basado en la evidencia
Faedo, C. M., Enterría, P. G., & González, L. L. (2005) · Endocrinología y Nutrición · doi:10.1016/s1575-0922(05)74652-0 · Cited by 2
Upright position mechanical ventilation: An alternative strategy for ALI/ARDS patients?
Zhu, M., Zhang, W., Wang, J., Yan, H., Li, Y., Ai, B., Fu, S.-L., & Fu, X. (2009) · Medical Hypotheses · doi:10.1016/j.mehy.2009.03.023 · Cited by 3
“The supine position seems to be an important risk factor in causing the aspiration of gastric contents [24].”
Background
Healthcare-associated infections must stop: a breakthrough project aimed at reducing healthcare-associated infections in an intensive-care unit
Yngstrom, D., Lindström, K., Nyström, K., Nilsson-Marttala, K., Hillblom, L., Hansson, L., Klarin, M., & Larsson, J. (2011) · BMJ Quality & Safety · doi:10.1136/bmjqs.2007.023846 · Cited by 2
Assessment Of Blood Pressure For Determining The Time To Perform First Postural Change In Patients After Cardiac Surgery In The Intensive Care Unit
Fujimoto, S. N. E. (2014) · Journal of Nursing & Care · doi:10.4172/2167-1168.1000177 · Cited by 2
“Prolonged bed rest leads to various complications in patients, including pneumonia [1], pressure ulcers [2], deep venous thrombosis [3], and joint contracture [4].”
Background
Is the evidence for the use of subglottic drainage to prevent ventilated-associated pneumonia sufficient to change practice?
Williams, T. A. (2012) · Australian Critical Care · doi:10.1016/j.aucc.2012.03.001 · Cited by 2
Factores relacionados con el cumplimiento de la posición semiincorporada en el paciente con ventilación mecánica según los profesionales: cuestionario CAPCRI-Q
Llauradó‐Serra, M., Baró, R. G., Lobo-Cívico, A., Castanera-Duro, A., Pi-Guerrero, M., Piñol-Tena, À., Paños-Espinosa, C., Calpe-Damians, N., Olona, M., Sandiumenge, A., et al. (2015) · Enfermería Intensiva · doi:10.1016/j.enfi.2015.07.005 · Cited by 2
Neumonía aspirativa en pacientes adultos mayores
Carrillo-Ñáñez, L., Muñoz-Ayala, M. P., & Carrillo-García, P. L. (2013) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) · doi:10.36393/spmi.v26i2.362 · Cited by 2
Campanha de sobrevivência à sepse: Diretrizes internacionais para tratamento de sepse grave e choque séptico: 2012
Schiller, F. (2013) · Cited by 2
Emergency Department Management of Severe Sepsis
Frakes, M. A. (2007) · Advanced Emergency Nursing Journal · doi:10.1097/01.tme.0000286965.79040.f1 · Cited by 2
“This simple intervention has reduced the incidence of ventilator-acquired pneumonia by more than 75% (Drakulovic et al., 1999).”
Background
SYSTEMIC INFLAMMATORY RESPONSE SYNDROME AND MULTIPLE-ORGAN DYSFUNCTION SYNDROME: DEFINITION, DIAGNOSIS, AND MANAGEMENT
Watkins, A. C., & Deitch, E. A. (2008) · Current Therapy of Trauma and Surgical Critical Care · doi:10.1016/b978-0-323-04418-9.50097-7 · Cited by 2
Effect of ventilator bundle implementation on weaning indicator among mechanically ventilated patients at a selected private healthcare sector
El-Sharkawy, M. E., Mohamed, W., & Ali, N. S. (2017) · Egyptian Nursing Journal · doi:10.4103/enj.enj_10_17 · Cited by 2
“Placing mechanically ventilated patients in a semirecumbent body position (45°) has been demonstrated to reduce the incidence of VAP to more than 75% compared with those placed in a completely horizontal position (0°) (Drakulovic et al., 1999).”
Background
The usability of classification NIC interventions in ventilator-associated pneumonia prevention
Hůsková, J., Juřeníková, P., & Mikšová, Z. (2017) · Kontakt · doi:10.1016/j.kontakt.2017.07.002 · Cited by 2
“[18] Drakulovic MB, Torres A, Bauer TT, Nicolas JM, Nogué S, Ferrer M.”
Background
Strategies for the Prevention of Ventilator-associated Pneumonia in the Intensive Care Units: A Review
Yekefallah, L., Shafaei, M., & Dehghankar, L. (2019) · The Journal of Qazvin University of Medical Sciences · doi:10.32598/jqums.23.4.352 · Cited by 2
“Some scholars have suggested that raising nurses' awareness and their compliance with the ICU guidelines can have a significant impact on reducing the incidence of VAP [17-19, 21, 20].”
Background
Core Elements of General Supportive Care for Patients with Sepsis and Septic Shock in Resource-Limited Settings
Mer, M., Schultz, M. J., Adhikari, N. K. J., Kwizera, A., Mohanty, S., Dondorp, A. M., Neto, A. S., & Preller, J. (2019) · Springer eBooks · doi:10.1007/978-3-030-03143-5_5 · Cited by 3
Энтеральная толерантность у критических пациентов (обзор литературы)
Maltseva, L. А., Mishchenko, О. О., Kutovyi, A. B., Мосенцев, Н. Ф., Lisnycha, V. M., & Kazimirova, N. A. (2020) · EMERGENCY MEDICINE · doi:10.22141/2224-0586.16.1.2020.196927 · Cited by 2
Prinzipien zur intensivmedizinischen Versorgung der schwangeren Patientin
Neuhaus, S., Neuhaus, C., Weigand, M. A., & Bremerich, D. H. (2021) · Der Anaesthesist · doi:10.1007/s00101-021-00947-2 · Cited by 2
“Zur Pneumonieprophylaxe können auch in der Schwangerschaft eine Oberkörperhochlagerung von 30° sowie die Anwendung antiseptischer Mundspülungen erfolgen [11, 12, 13].”
Background
Prognosis of patients with tracheal intubation in the emergency department
Sarbazi-Golezari, A., Namdar, P., Yousefian, S., Mirzadeh, M., Farnood, A., & Modirian, E. (2021) · Trends in Anaesthesia and Critical Care · doi:10.1016/j.tacc.2021.07.008 · Cited by 2
Adherence to Head-of-Bed Elevation in Traumatic Brain Injury: An Audit
Chitteti, P., George, A. S., Nair, S., Karuppasamy, R., & Joseph, M. (2022) · Journal of Neuroanaesthesiology and Critical Care · doi:10.1055/s-0042-1758749 · Cited by 2
Incidence of postoperative pneumonia in various surgical subspecialties: a retrospective study
Alrefaei, M. I., Ahmed, R. A., & Althoubaity, F. (2024) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000002453 · Cited by 2
“Limited mobility can exacerbate this risk [18,35] .”
Background
Acute Lung Injury and Acute Respiratory Distress Syndrome (ALI/ARDS)
Howell, D. C. J., & Bellingan, G. J. (2009) · Competency-based critical care · doi:10.1007/978-1-84882-095-1_1 · Cited by 2
“Of note, nursing patients in the 45° semi-recumbent position has been shown to decrease VAP [ 37 ] and is a simple manoeuvre that should be widely adopted.”
Background
Theorie und Praxis der enteralen Ernährung
Ockenga, J., & Lochs, H. (2003) · Intensivmedizin und Notfallmedizin · doi:10.1007/s00390-003-0398-8 · Cited by 1
27 Bundels
Smorenburg, S. M. (2006) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-1100-2_27 · Cited by 2

Authors: Drakulovic, M. B., Torres, A., Bauer, T. T., Nicolas, J. M., Nogué, S., & Ferrer, M.
Affiliations: Hospital Clínic de Barcelona (ES)
ORCID: Bauer, Torsten T
Nogué, Santiago
Ferrer, Miquel
Venue: The Lancet
Publisher: Elsevier BV
Published: 1999-11
Volume: 354
Issue: 9193
Pages: 1851-1858
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(98)12251-1
OpenAlex: W2143385226
Cited by: 1,243
References: 37
Citations by year: 2026: 15 · 2025: 13 · 2024: 19 · 2023: 19 · 2022: 22 · 2021: 20 · 2020: 19 · 2019: 20 · 2018: 25 · 2017: 44 · 2016: 40 · 2015: 50 · 2014: 60 · 2013: 58 · 2012: 61
FWCI: 31.48
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords: nosocomial pneumonia, semi-recumbent position, mechanical ventilation, intensive care unit patients, enteral nutrition, risk factors, mechanical ventilation duration, Glasgow Coma Scale
MeSH terms: Aged, Analysis of Variance, Cross Infection, Enteral Nutrition, Female, Humans, Intensive Care Units, Male, Middle Aged, Pneumonia, Aspiration, Posture, Respiration, Artificial, Risk Factors, Spain, Time Factors, Incidence, Logistic Models, Odds Ratio, Supine Position, Hospital Mortality

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Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised trial

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