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Effect of two different feeding methods on preventing ventilator associated pneumonia in the paediatric intensive
Duygu Sönmez Düzkaya1, Suzan Yildiz2
1Istanbul University, Istanbul Faculty of Medicine, Directorate of Nursing Services, Education Nurse, Çapa-Fatih, Istanbul, Turkey.
Insights
Nasoduodenal feeding may reduce ventilator-associated pneumonia (VAP) in children, though results were not statistically significant. This study compared nasoduodenal (ND) versus nasogastric (NG) feeding in the paediatric intensive care unit (PICU) to prevent VAP.
Area of Science:
- Pediatric Intensive Care
- Infectious Disease Prevention
- Clinical Nutrition
Background:
- Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in intubated children in the paediatric intensive care unit (PICU).
- Nurses play a key role in VAP prevention, utilizing various procedures.
- The efficacy of enteral nutrition in VAP prevention is debated.
Purpose of the Study:
- To compare the effectiveness of continuous nasoduodenal (ND) feeding versus intermittent nasogastric (NG) feeding in preventing VAP in PICU patients.
- To evaluate the impact of different enteral feeding methods on VAP incidence.
Main Methods:
- A randomized controlled experimental study design was employed.
- Forty pediatric patients were randomly assigned to either ND (n=20) or NG (n=20) feeding groups.
- VAP assessment used the clinical pulmonary infection score and CDC criteria, adhering to VAP prevention bundles.
Main Results:
- The overall incidence of VAP in the study population was 15%.
- The VAP rate was 10% in the ND group and 20% in the NG group.
- No statistically significant difference in VAP incidence was found between the ND and NG feeding groups (p=0.661).
Conclusions:
- While not statistically significant, nasoduodenal feeding demonstrated a trend towards reducing VAP incidence.
- Further research may be warranted to confirm the potential benefits of ND feeding in VAP prevention.
Background:
For infants and children who require intubation in the paediatric intensive care unit (PICU), ventilator-associated pneumonia (VAP) is a significant cause of secondary morbidity and mortality linked with extended use of intubation. Nurses are primarily responsible for the prevention of VAP and there are a number of procedures that contribute towards this end. Although enteral nutrition has been reported to be effective in the prevention of VAP, this remains controversial.
Objective:
To compare and evaluate the effects of intermittent feeding through a nasogastric catheter with those of continuous feeding through a nasoduodenal catheter in preventing VAP in the PICU.
Design:
The research design was a randomised, controlled experimental study.
Methods:
Forty paediatric patients were randomised and divided into two groups of 20: one group for nasoduodenal (ND) feeding and the other for nasogastric (NG) feeding. Patients were assessed for the development of VAP using the clinical pulmonary infection score and Centers for Disease Control and Prevention criteria while working in accordance with the VAP prevention bundles introduced within the unit.
Results:
The incidence of paediatric VAP was 15%. The rate of VAP in patients who were ND fed was 10%, whereas the rate of VAP in patients who had NG feeding was 20%. No statistically significant difference was observed between the ND- and NG-fed patients (p=0.661).
Conclusion:
Although the results of our study were not statistically significant, nasoduodenal feeding helped to reduce the incidence of VAP.
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