تأثیر شیب تخت 45 درجه در پیشگیری از پنومونی وابسته به ونتیلاتور در بیماران بستری در بخش‌های مراقبت ویژه

Background & Aim: The prevention of  ventilator-associated pneumonia (VAP) can decrease the duration of mechanical ventilation, length of hospital stay, and healthcare costs. One of the interventions is raising the head of bed (HOB) to 45 degrees. This study was perfomed with the aim of determining the effect of the HOB elevation to 45 degree on the incidence of VAP on hospitalized in Intensive Care Unit (ICU).   Materials & Methods: This study was a randomized clinical trial. It consisted of 80 patients who were under mechanical ventilation and hospitalized in Intensive Care Unit (ICU) from February to July 2016 in the selected governmental hospitals affiliated to Iran University of Medical Sciences. The samples were assigned to two groups, i.e. control and intervention, using a randomised block method. The patients in intervention and control groups had HOB elevation to 45 degree and  routine position for three consecutive days. In both groups,  HOB elevation in every shift was measured using the goniometer and was recorded by nurses in the angel of bed form. At the end of the third day, ventilator-associated pneumonia was evaluated, using the Clinical Pulmonary Infection Score (CPIS). Data analysis was performed with chi-square, Fisher’s exact test, and T- Test via SPSS v.20. Results: There was a statistically significant difference between two groups with regard to VAP (P-value=0.002). The incidence of VAP were 52.5% in the control group and 20% in the intervention group. Conclusion: According to the results of this study, HOB elevation of 45 degree were effective in preventing VAP. Hence, it is recommended that the patients hospitalized in ICU,and under mechanical ventilation, should be positioned 45 degree according to their conditions.