Farshid Rahimi Bashar; Ebrahimi Khoshraftar; Reza Tahmasebi; Mohammad Reza Hajiesmaeili; Shahram Seif; Alireza Sedaghat; Amir Vahedian-Azimi; Hosna Forooghirad; Ali Dabbagh
Volume 19, Issue 2 , February 2017, , Pages 1-8
Abstract
Background: Nutritional therapy in the forms of parenteral or enteral nutrition is an important factor of care and appears to positively impact the clinical outcomes of critically ill patients.Objectives: This study aimed to compare the effects of acupuncture and prokinetic drugs on delayed gastric emptying ...
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Background: Nutritional therapy in the forms of parenteral or enteral nutrition is an important factor of care and appears to positively impact the clinical outcomes of critically ill patients.Objectives: This study aimed to compare the effects of acupuncture and prokinetic drugs on delayed gastric emptying (DGE) in intensive care unit patients.Methods: In a prospective, block-randomized, single-blinded, parallel group trial, 60 fully sedated, mechanically ventilated surgical patients were enrolled in two groups with 30 patients in each group in Besat hospital in Hamadan, Iran from February 2011 to October 2012. Patients in the drug treatment group received 10 mg of IV metoclopramide every eight hours. For patients with whom persistent DGE was seen, 500 mg of IV erythromycin every 24 hours was added. Patients in the acupuncture group received bilateral prolonged intermittent transcutaneous electrical acupoint stimulation of acupuncture point Neiguan. The intervention was performed for six consecutive days or until the cessation of gradual residual volume.Results: A demographic analysis of the participants revealed no significant differences between groups (P > 0.05). Although the results of the RANOVA model for DGE did not show a significant time trend (P > 0.05) in both acupuncture and drug groups, comparing means of the both acupuncture and drug groups in all the time points after the intervention were significant (P = 0.024):711.83 ± 193.28 vs. 755.00 ± 166.79 (P = 0.358), 564.17 ± 672.35 vs. 628.50 ± 176.77 (P = 0.614), 324.00 ± 146.49 vs. 472.00 ± 188.47 (P < 0.001), 209.00 ± 136.34 vs. 340.00 ± 211.89 (P < 0.006), 152.67 ± 118.93l vs. 276.17 ± 202.43 (P < 0.006), and 119.67 ± 101.59 vs. 225.67 ± 184.22 (P < 0.008) from the first to last steps, respectively.Conclusions: Although neither acupuncture nor the drug interventions had significant effects on the improvement and obviation of DGE, the acupuncture had greater effects than prokinetic drugs on the reduction of DGE.
Roya Farzanegan; Maryam Alehashem; Behrooz Farzanegan; Sharareh R Niakan Kalhori; Mohammad Gholami Fesharaki; Farshid Rahimi Bashar; Behjat Barari; Mahdi Zangi; Mohammad Behgam Shadmehr
Volume 19, Issue 1 , January 2017, , Pages 1-11
Abstract
Background: Tracheal stenosis is one of the worst complications of endotracheal intubation, but timely diagnosis can change its natural history. Management of these patients places a great burden on the health care system and the well-being of the patients and their families. Therefore, discharged intensive-care-unit ...
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Background: Tracheal stenosis is one of the worst complications of endotracheal intubation, but timely diagnosis can change its natural history. Management of these patients places a great burden on the health care system and the well-being of the patients and their families. Therefore, discharged intensive-care-unit (ICU) patients who underwent more than 24 hours of intubation should be actively followed-up 3 months after extubation and screened for post-intubation tracheal stenosis. The present study was aimed at assessing the impact of post-discharge follow-up call interviews on increasing successful screening for post-intubation tracheal stenosis.Objectives: To determine the effect of post-discharge call interviews on improving screening of post-intubation tracheal stenosis.Methods: This experimental study was conducted in Iran in September 2014. Using the simple randomization method, 140 patients who had undergone than 24 hours of endotracheal intubation and had received oral and written educational materials upon discharge from the ICU were equally assigned to an intervention and a control groups (received a call interview before or after the follow-up due date, respectively). The needed sample size was calculated to be 70 participants in each group (considering α = 5%, the statistical power of 90%, and effect size = 0.4).Results: There was a significant difference in follow-up rates at the due date between the intervention group (50.7%, 34of 67 participants) and the control group (17.5%, 11 of 63 participants) (OR = 4.871, 95% CI = 2.172 to 10.924, P < 0.0001). In the control group, the call interviews significantly increased the follow-up rate from 17.5% to 66.7 % (42 of 63 participants) (P < 0.0001), although followup occurred after the due date. The results of the logistic regression model showed that the patients who had attempted suicide completed follow-up more than those who had not (P = 0.017), that interviews with patients and their parents were more effect than interviews with others (P < 0.05), and that phone call interviews after the follow-up due date were more effective than those before the follow-up due date (OR = 2.653, 95%CI = 1.079 to 6.526, P = 0.034).Conclusions: We highly recommend making call interviews, along with distributing the oral and written educational materials, to increase the follow-up rate among discharged ICU patients.
