Endotracheal Tube Repositioning Frequency for Preventing Oral Mucosal Pressure Injuries in Intensive Care Units: A...

Area of Science:

• Critical Care Medicine
• Nursing Science
• Patient Safety

Background:

• Mechanically ventilated patients in the ICU are at high risk for oral mucosal membrane pressure injuries (MMPIs) due to sustained endotracheal tube (ETT) pressure and friction.
• Developing effective strategies to prevent MMPIs is crucial for improving patient outcomes and comfort in the ICU setting.

Purpose of the Study:

• To compare the efficacy of 4-hour versus 8-hour endotracheal tube (ETT) repositioning intervals in preventing oral MMPIs.
• To provide evidence-based guidance for optimizing nursing care protocols related to ETT management in intensive care units (ICUs).

Main Methods:

• An analyst-blinded, parallel-group randomized controlled trial involving adult ICU patients receiving invasive mechanical ventilation (MV).
• Patients were randomized (1:1) to either 4-hour or 8-hour ETT repositioning intervals, stratified by Acute Physiology and Chronic Health Evaluation System (APACHE II) scores.
• The primary outcome was the development of oral MMPIs assessed using the Reaper Oral Mucosa Pressure Injury Scale-TR over a 14-day follow-up period.

Main Results:

• The primary hypothesis posits that a 4-hour ETT repositioning interval will significantly decrease the incidence of oral MMPIs compared to an 8-hour interval.
• More frequent repositioning is anticipated to better maintain mucosal integrity and enhance patient comfort.
• The study aims to provide data supporting standardized nursing-led ETT care protocols in ICUs.

Conclusions:

• This study investigates ETT repositioning frequency in relation to patient disease severity.
• Findings may support the development of more standardized, patient-centered preventive strategies for MMPIs.
• The research contributes to safer and more efficient nursing care in intensive care settings.