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Semi recumbent body position fails to prevent healthcare associated pneumonia in vietnamese patients with severe tetanus

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Assessed for eligibility n=419 Excluded n=187 ♦ In a previous hospital for > 24 h n=93 ♦ Not admitted to ICU n=88 ♦ Not tetanus n=6 Analysed n=104 At risk of HCAP, remained semi-recumben

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Transactions of the Royal Society of Tropical Medicine and Hygiene 106 (2012) 90– 97

jo u rn al h om epa g e : h t tp :/ / w w w e l s e v i e r c o m / l o c a t e / t r s t m h

Huynh Thi Loana, Janet Parryb,c, Nguyen Thi Ngoc Ngaa, Lam Minh Yena,

Nguyen Thien Binha, Tran Thi Diem Thuya, Nguyen Minh Duonga, James I Campbellb,c, Louise Thwaitesb,c, Jeremy J Farrarb,c, Christopher M Parryb,c,∗

a Hospital for Tropical Diseases, 190 Ben Ham Tu, District 5, Ho Chi Minh City, Vietnam

b The Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, 190 Ben Ham Tu, District 5, Ho Chi Minh City Vietnam

c Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK

a r t i c l e i n f o

Article history:

Received 16 April 2011

Received in revised form 7 October 2011

Accepted 7 October 2011

Keywords:

Tetanus

Healthcare-associated pneumonia

Body position

Semi-recumbent

Tracheostomy

Vietnam

a b s t r a c t

Healthcare-associatedpneumonia (HCAP)is acommoncomplication inpatients with severetetanus.Nursingtetanuspatientsinasemi-recumbentbodypositioncouldreduce theincidenceofHCAP.Inarandomisedcontrolledtrialwecomparedtheoccurrenceof HCAPinpatientswithseveretetanusnursedinasemi-recumbent(30◦)orsupineposition

Atotalof229adultsandchildren(aged≥1year)withseveretetanusadmittedtohospital

inVietnam,wererandomlyassignedtoasupine(n=112)orsemi-recumbent(n=117) position For patients maintaining their assigned positions and in hospital for>48h therewasnosignificantdifferencebetweenthetwogroupsinthefrequencyofclinically suspectedpneumonia[22/106(20.8%)vs26/104(25.0%);p=0.464],pneumoniarate/1000 intensivecareunitdays(13.9vs14.6;p=0.48)andpneumoniarate/1000ventilateddays (39.2vs38.1;p=0.72).Mortalityinthesupinepatientswas11/112(9.8%)comparedwith 17/117(14.5%)inthesemi-recumbentpatients(p=0.277).Theoverallcomplicationrate [57/112(50.9%)vs76/117(65.0%);p=0.03]andneedfortracheostomy[51/112(45.5%)vs 69/117(58.9%);p=0.04)wasgreaterinsemi-recumbentpatients.Semi-recumbentbody positioningdidnotpreventtheoccurrenceofHCAPinseveretetanuspatients.[Clinical Trials.govIdentifier:NCT01331252]

© 2011 Royal Society of Tropical Medicine and Hygiene Published by Elsevier Ltd

All rights reserved

1 Introduction

Tetanusisanimportantcauseofmorbidityand

mor-tality throughout the developing world Despite the

availabilityofaneffectivevaccine,anestimatedonemillion

casesoftetanusstilloccureachyear.1Theprincipalcauses

of death in tetanus are respiratory failure and

cardio-vasculardysfunctionsecondarytoautonomicinstability.2

∗ Corresponding author Present address: Oxford University Clinical

Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, District 5,

Ho Chi Minh City, Viet Nam Tel.: +84 8 9 241 761; fax: +84 8 9 238 904.

E-mail address: cparry@oucru.org (C.M Parry).

The ability to be able to perform a tracheostomy and mechanicallyventilatepatientshascontributedtoa signif-icantreductioninmortalityduetorespiratoryfailure3–5

butleadstoanincreasein thefrequency of healthcare-associated pneumonia (HCAP).6,7 The management of patientswithpneumoniaiscomplicatedbydiagnostic dif-ficultiesandthedevelopmentofresistancetocommonly usedantimicrobialagents,problemsparticularlyacutein resource-limitedsettings.Simpleandinexpensive strate-giestoreducetherisk of HCAPin patientswithsevere tetanuswouldbevaluable

Positioningofmechanicallyventilatedpatientsinthe semi-recumbentpositionat30–45◦isnowgenerally rec-ommendedasapneumoniapreventativemeasure.8–10In

0035-9203/$ – see front matter © 2011 Royal Society of Tropical Medicine and Hygiene Published by Elsevier Ltd All rights reserved.

doi: 10.1016/j.trstmh.2011.10.010

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an unpublishedpilot study conducted by our group in

20patientswithseveretetanusattheHospitalfor

Trop-icalDiseases(HTD)inHoChiMinhCity,Vietnam,patients

wereunabletotolerateasemi-recumbent positionata

45◦anglebecauseofmusclerigidity.However,a30◦angle

wastoleratedbythepatientsanddidnotappeartocause

anyadverseeventssuchashypotension.Weinvestigated

thehypothesisthattheincidenceofHCAPinpatientswith

severetetanuscouldbereducedbynursingpatientsina

semi-recumbentpositionat30◦ratherthaninthesupine

position,aswasthecurrentwardpractice

2 Methods

2.1 Studypopulation

ThestudywasconductedattheHTD,HoChiMinhCity,

Vietnam.This500-bedinfectiousdiseasehospitalserves

thelocalcommunityandisaspecialistreferralcentrefor

thesurroundingprovincesforsevereinfectiousdiseases

suchastetanus.Thehospitaladmitted250–300casesof

tetanuseach yeartoa ward exclusivelydevotedto the

managementofpatientswithtetanus.Thewardcontained

a 14-bed intensive care unit (ICU) for adults, children

andneonateswithseverediseaseandaseparateareafor

patientswithnon-severediseaseandthoseintherecovery

phase

Consecutiveadultsandchildren(aged≥1year)

admit-tedtotheICUwithaclinicaldiagnosisofseveretetanus

wereeligible.Patientswereexcludediftheyhadbeenin

anotherhospitalformorethan24hpriortoadmissionto

HTD,iftheyhadaclinicaldiagnosisofpneumonia(defined

below)atthetimeofadmission,shockrefractoryto

vasoac-tivedrugsorvolumetherapy,recentICUstay(<30days),

recentabdominalsurgery(<7days)orwereagedunder

1year.Foreacheligiblepatient,anopaqueenvelope

con-tainingthenextstudynumberwasopenedcontaininga

randomallocationina1:1ratiotoeithersemi-recumbent

(30◦)orsupine(0◦)bodyposition.Therandomisationwas

byacomputer-generatedlistbyastaffmembernot

other-wiseinvolvedinthestudy.Theattendingphysicianswere

responsibleforenrollingtheparticipants,andrecording

theclinicaldataintheindividualstudynotes.Healthcare

personnelwereinstructednottochangethepositionofthe

patient,unlessformedicalrequirements.Thecorrectness

ofthepositionwascheckedtwicedailybyamemberofthe

studyteam.Semi-recumbentpatientswerelaidsupineif

thepatienthadacardiacarrest,orhypotensiondeveloped

forlongerthan30min.Allpatientsweresupineduring

tra-cheostomyandfor30minafterwards

2.2 Patientmanagement

Wounds,ifpresent,werecleanedanddebrided,equine

tetanus antitoxin was administered in a dose ranging

from 500 to 100 IU/kg depending on the extent of

the disease and penicillin or metronidazole was given

(penicillin 100000–200000IU/kg/day or metronidazole

1600mg/dayrectally)for7–10days,changingtoanoral

preparationwhenthepatientwaswellenough

Benzodi-azepines(diazepamormidazolam20–240mg/dayeither

asabolusorbyi.v.infusion)weregiventocontrol mus-cle spasmandhypertonia.Theindications forasurgical cuffedtracheostomywereacuteairwayobstructiondueto laryngealspasm,frequentspasmsinterferingwith respi-rationortofacilitatemechanicalventilation.Nopatients were orally intubated and no form of subglottic suc-tion or selective digestive tract decontamination was used Arterial blood gases and peripheral oxygen satu-rationsweremonitoredregularly.In severetetanus,the non-depolarizingneuromuscularblockingagent pipecuro-niumwasused,usingbolusdosestitratedagainstspasm Autonomic instability wastreated withincreased seda-tion,morphine (20–60mg/dayintramuscularly),calcium antagonists,digoxin,volumeexpansionorinotropes (nore-pinephrineordopamine)accordingtotheclinicalsituation Intermittententeralnutrition wasadministeredthrough

alargeborenasogastrictubeinthosepatientsunableto swallow.AnX-raywasusedtodeterminecorrect place-mentofthetubebeforefeedingcommenced.Patientswith

ahistoryofpreviousgastriculcerationcontinuedtoreceive theirregularmedication,andthose whodeveloped gas-trointestinalbleedingduringthecourseoftheiradmission werecommencedonstressulcerprophylaxiswitheither

anH2antagonistorsucralfate.Standardmeasuresfor gen-eralcriticalcareandpreventionofnosocomialpneumonia wereemployedandapressureareacareprotocolwas fol-lowedinallpatients.Closedsuctionwasusedforbronchial toilet.Onaveragethereweretwopatientsforeachnurse

intheICU

Admissionclinicalfeatures,thepresenceofunderlying disease,dailyprogress,theneedforatracheostomyand mechanicalventilation, durationandtypeofnasogastric intubation,typeofstressulcerprophylaxis,sedative treat-mentadministered,intercurrentinfectionsantimicrobial treatmentgiven,thecostofantimicrobialsgivenandthe durationofICUandhospitalstaywerecollected prospec-tivelyonadedicatedstudyform.Atthetimeofadmission

tothe ICU,blood wastaken for haematocrit,white cell count,plateletcountandcreatinineandachestX-ray per-formed.Thetetanusseverityscore(TSS)wasdetermined for the time of admission witha cut-off point TSS ≥8

as predictiveofdeath.11Olderagewasdefined asaged

>60years;prolongedventilationwasdefinedas mechani-calventilation>7days;hypotensionwasdefinedinadults

asasystolicbloodpressure≤80mmHgandinchildrenasa systolicbloodpressure≤70mmHg;thepresenceof auto-nomicinstabilitywasdiagnosedbytheattendingphysician

onthebasisofthepresenceoflabilityintheheartrate, bloodpressure,temperatureorexcessivesweating 2.3 Pneumoniasurveillance

Surveillanceforpneumoniaorotherinfectionwas con-ducteddailyuntildeathor72hafterthepatienthadleft theICU.Patientswithclinicallysuspectedpneumoniawere investigated withachest X-ray,whiteblood cellcount, blood culture and non-bronchoscopic bronchial lavage Clinicalpneumoniawasdefinedbythepresenceofnew andpersistentinfiltratesonchestX-ray,consideredlikely

tobe associated withpulmonaryinfection, and atleast twoofthefollowingthreecriteria:temperatureof≥38◦C,

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pres-enceofpurulenttrachealsecretions.Themicrobialcause

ofthepneumoniawasdeterminedbytheisolationofat

least one pathogenic microorganism in a blood culture

oratleastonepathogenicmicroorganismintheculture

ofthenon-bronchscopiclavagewiththebacterialgrowth

≥105colonyformingunits(CFU)/ml.Community-acquired

pneumoniawasdefinedaspneumoniadevelopingwithin

48hofadmissiontoanyhospitalandHCAPaspneumonia

developingmorethan48hafteradmissiontoanyhospital

Thediagnosisofpneumoniawasconfirmedbyan

indepen-dentphysician,nototherwiseinvolvedinthedailyconduct

ofthestudy

2.4 Microbiologicalmethods

Blood,5–8ml(foradults)or2–5ml(forchildren),was

inoculatedintoBACTECplusaerobicbottles(Becton

Dick-inson,Sparks,MD,USA).Thesebottlescontainaresinto

adsorbantimicrobials.Thebottleswereincubatedat37◦C

in theBACTEC9050automated analyserfor 5days and

subculturedwhenthemachineindicatedapositivesignal

Patients were pre-oxygenated prior to the

non-bronchoscopic bronchial lavage.12 They were already

sedated by the tetanus therapy Secretions in the

tra-cheaandtracheostomywereremovedbysterilesuction

A standard50cm,14-gauge tracheal aspirationcatheter

(ArgyleSherwoodMedical,London,UK)wasattachedto

a 20ml syringefilled with20mlof sterilesaline(10ml

for children).The distal endwas lubricatedwithsterile

gel,introducedviathetracheostomytubeandadvanced

until significant resistancewas encountered Thesaline

wasinstilledover 10–15s, withdrawn1–2cm and then

immediatelyre-aspiratedandthecatheterwasremoved

Generally5–10mloffluidwasrecovered.Nofurther

aspi-ration wasattemptedduringremoval ofthecatheterto

avoidcontaminationwithtrachealsecretions

Sampleswereprocessedin thelaboratorywithin1h

ofcollection.A Gramstainand Ziehl–Neelsenstainwas

prepared from thelavage fluid, which was then mixed

withanequal volumeof freshly prepareddithiothreitol

(Sputasol;Oxoid,Basingstoke,UK).Themixturewasleft

atroomtemperaturefor10minduringwhichtimeitwas

shakenvigorouslyonthreeoccasions.Threeserialtenfold

dilutionsweremadebytransferring1mlofthemixture

to9mlofmaximumrecoverydiluent(Oxoid,Basingstoke,

UK).Analiquotof20␮loftheoriginalhomogenised

sam-pleandeachofthethreedilutionswasinoculatedonhalf

aplateeachofthefollowingmedia:5%sheepbloodagar,

heatedblood agar,aselectivepneumococcalagar

(incu-bated at 37◦C in 5% CO2 for up to48h),a MacConkey

agaranda furtherMacConkey agarcontaining4mg/l of

gentamicin(incubatedat37◦Cinairfor upto48h)(all

mediafromOxoid,Basingstoke,UK).Specificculturesfor

Legionella species and Mycobacteria spp were not

per-formed.After24and48hincubationcoloniesoneachof

theplateswerecountedandconvertedtoabacterial

con-centrationinCFU)/mloforiginallavagefluid

Isolated organismswereidentifiedby standard

labo-ratorymethodsusingAPIidentificationkits(Bio-Mérieux,

Basingstoke,UK)whennecessary.Thefollowingorganisms whenisolatedinthenon-bronchiallavagewereconsidered non-pathogenic:Streptococcusspp.exceptS.pneumoniae, coagulase negative staphylococci, Neisseria spp and Candida spp Antimicrobial susceptibility testing was performedbythemodifiedKirby-Bauermethodand inter-pretedaccordingto CLSI(formerlyNCCLS) guidelines.13

Theantimicrobialtherapyofthepatientswasadjustedin thelightofthemicrobiologyresults

2.5 Samplesizeandstatisticalanalysis Theaimofthestudywastoassessthefrequencyand rateofdevelopmentofclinicallysuspectedand microbi-ologicallyconfirmed HCAPin tetanuspatientsadmitted

totheICU nursedin a semi-recumbent orsupine body position.Thefrequencyofclinicallyandmicrobiologically confirmedHCAPwasdefinedasthenumberofcasesper

100patientsandtherateasthenumberofcasesper1000 ICUdaysandper1000ventilateddays.Patientsatriskof developingHCAPwerethosewhohadbeeninhospitalfor

atleast2dayswithoutdevelopingpneumonia.Analysisof admissionstothewardduring1998and1999hadshown thatapproximately85% ofpatientsadmittedtotheICU wereatrisk,and39%developedHCAP.Inordertoshow

a50%reductioninthefrequencyofHCAPinthosepatients nursedinasemi-recumbentposition190at-riskpatients (95%confidencelevel,80%power)wouldberequired.We plannedto conductan analysis when 230patientshad beenrecruitedtothestudy.Asecondaryend-pointwasa comparisonofthemortalityineachgroupandthiswas per-formedonanintention-to-treatbasis.Patientseitherdied

inhospital,orweretakenbytherelativestodieathome whentherewasnofurthertreatmentpossibleandno like-lihoodofsurvivalintheviewoftheattendingphysician Thosetakenhometodiewererecordedasdeaths Categoricalvariableswerecomparedusingthe␹2test

orFisher’sexacttest.Non-parametricdatawascompared usingtheMann-WhitneyUtest.Riskfactorsforthe devel-opmentofHCAPanddeathwerecalculatedbyunivariate andmultivariatemethods.Analysiswasperformedusing SPSSversion18.0(SPSSInc.,Chicago,IL,USA)andEpiInfo v6(CDC,Atlanta,GA,USA)

3 Results 3.1 Studypopulation Therewere419admissions(excludingneonates)tothe tetanuswardbetweenAugust2000andMarch2002.Six patientswereimmediatelyexcludedastheydidnothave tetanus,88werenotsevereenoughtorequireadmission

totheICUand93hadbeeninaprevioushospitalfor>24h

Atotalof 232patientswereentered intothestudyand randomised(Figure1):115patientswererandomisedto

benursedinasupinepositionand117tobenursedina semi-recumbentposition.Threesupinepatientswere sub-sequentlyconsiderednottohavetetanusand excluded Theonlyimportantdifferenceinthecharacteristicsofthe twogroupsofpatients,atthetimeofadmission,wasthata significantlyhigherproportionofsemi-recumbentpatients

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Assessed for eligibility (n=419)

Excluded (n=187)

♦ In a previous hospital for > 24 h (n=93)

♦ Not admitted to ICU (n=88)

♦ Not tetanus (n=6)

Analysed (n=104)

At risk of HCAP, remained

semi-recumbent

26 (25%) developed HCAP

Lost to follow-up (n=0)

Died within 48 h of admission (n=6)

Changed to supine position (because of

hypotension) (n=7)

Allocated to semi-recumbent position

(n=117)

♦Received allocated intervention (n=117)

♦Did not receive allocated intervention

(n=0)

Lost to follow-up (n=0) Died within 48 h of admission (n=5) Self discharged (n=1)

Allocated to supine position (n=115)

♦Received allocated intervention (n=112)

♦Did not receive allocated intervention (not tetanus) (n=3)

Analysed (n=106)

At risk of HCAP, remained supine

22 (20.8%) developed HCAP

ALLOCATION

ANALYSIS FOLLOW-UP

Randomised (n=232)

ENROLMENT

Figure 1 CONSORT flow chart demonstrating recruitment of patients to the study HCAP: healthcare-associated pneumonia; ICU: intensive care unit.

hadpreviouslyreceivedanantimicrobial(Table1).There

wasnosignificantdifferenceintheTSSbetweenthetwo

groups

3.2 Pneumoniasurveillance

A clinical diagnosis of pneumonia was made in 55

patientsanda microbiologicaldiagnosisin45(Table2)

Ofthe55 patientswithpneumonia 53(96%) hada

tra-cheostomy at the time and 50 (91%) were receiving

mechanicalventilation.Therewasnosignificantdifference

intheoverallnumberofpatientswithaclinicalor

microbi-ologicaldiagnosisofpneumoniabetweeneachgroup.The

frequencyofpneumonia inthesupinegroupwaslower

thanwehadexpected,althoughtherangeoforganisms

iso-latedwastypicalofourpreviousexperienceontheward

(Table2)

Fivepatientsrandomised tothesupine positiondied

within48hofadmissionandonepatientself-discharged

ontheseconddayofadmission.Sixpatientsrandomisedto thesemi-recumbentpositiondiedwithin48hofadmission andsevenpatientshadtochangepositiontosupine,one becauseofacardiacarrestonday1andsixbecausethey developedhypotensionatsomepointbetweendays2and

6.Therefore,106supinepatientsand104semi-recumbent patientswere eligiblefor analysisof thefrequency and rateofHCAP(Figure1;Table2).Thiswasmorethanthe intendedsamplesizeof190at-riskpatients.The propor-tion of patients with HCAP was 22/106 (20.8%) in the supinegroupand26/104(25.0%)inthesemi-recumbent group[odds ratio(OR)0.79, 95% CI0.39–1.57, p=0.46)

In thepatients treated with a tracheostomythe corre-spondingproportionswere22/49(44.9%)vs26/59(44.1%) (OR1.03,95%CI0.45–2.38,p=0.93)andforthepatients requiring mechanical ventilation the proportions were 21/37(56.8%)vs24/44(54.5%)(OR1.09,95%CI0.41–2.90,

p=0.84).Therewerealsonosignificantdifferencesinthe rates of HCAP/100 ICU days and HCAP/1000 ventilated

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Table 1

Comparison of the admission characteristics of all patients recruited into the study

Supine (n = 112)

Semi-recumbent (n = 117)

p-value

Entry site

Mean (range) tetanus severity score 2.31 (−6 to 25) 1.91 (−5 to 22) 0.582 Mean (range) white cell count (×10 9 /l) 9.5 (5.3–14.7) 8.4 (5.5–14.7) 0.503

Data are number (%) unless otherwise indicated.

Table 2

Clinical and microbiological pneumonia in 229 study patients

Supine Semi-recumbent Odds ratio (95% CI) p-value (n = 112) (n = 117)

Patients with clinical diagnosis of pneumonia 26 (23.2%) 29 (24.8%) 0.92 (0.48–1.76) 0.78 Patients with microbiological diagnosis of pneumonia 19 (17.0%) 26 (22.2%) 0.72 (0.35–1.45) 0.32 Organisms isolated a

Pseudomonas aeruginosa 8 11

Klebsiella spp 10 (1) 11 (1)

Streptococcus pneumoniae 3 3

Patients who developed HCAP 2 (>48 h after admission to hospital) 22/106 (20.8%) 26/104 (25.0%) 0.79 (0.39–1.57) 0.46 Patients with a tracheostomy who developed HCAP 22/49 (44.9%) 26/59 (44.1%) 1.03 (0.45–2.38) 0.93 Ventilated patients who developed HCAP 21/37 (56.8%) 24/44 (54.5%) 1.09 (0.41–2.90) 0.84

HCAP rate/1000 ventilated days 39.2 38.1 0.72 Mean (range) cost of antimicrobials for pneumonia treatment (US$/patient) 228 (56–611) 215 (9–933) 0.84 Data are number (%) unless otherwise indicated.

HCAP: healthcare-associated pneumonia; ICU: intensive care unit.

a Organisms isolated from blood, or from the non-bronchoscopic lavage (≥10 5 CFU/ml) Number in parentheses refers to the isolation of the organism from blood culture.

days.HCAPonlydevelopedinthepatientsmanagedwith

a tracheostomy.In this group ofpatients, by

multivari-ateanalysisthedevelopmentofclinicalpneumoniawas

independently associated witholderage(p=0.086) and

durationofmechanicalventilationformorethan7days

(p<0.001)

3.3 Outcomeandadverseevents

The proportion of patients who required a

tra-cheostomy, and theoverall frequency of complications,

was significantly greater by univariate analysis in the

patientsnursedinthesemi-recumbentpositioncompared

withthose nursedinthesupine position(Table3).The

mortalityinthepatientsrandomisedtothesupineposition

was11/112(9.8%)comparedwith17/117(14.5%)inthose

randomised to the semi-recumbent position (OR 0.64, 95%CI0.27–1.53,p=0.277).Otheroutcomevariableswere similarineachgroup.Independentriskfactorsassociated withafataloutcomebymultivariateanalysiswereanolder age(p<0.001),currentorpreviousinjecting drugabuse (p<0.001) and the occurrence of autonomic instability (p<0.001).Inthe36patientswithaTSS≥8,themortality was19(52.8%)comparedwith9(4.7%)inthe193patients withaTSS<8(OR22.9,95%CI8.2–65.4,p<0.001)

4 Discussion

Inthisstudyasemi-recumbent(30◦)orsupine nurs-ingpositionforpatientswithseveretetanushadnoeffect

onthefrequencyandrateofHCAP.Thisresultcontrasts with two previous studies in general ICU patients A

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Table 3

Outcome in 229 study patients

Supine Semi-recumbent Odds ratio (95% CI) p-value (n = 112) (n = 117)

Mechanical ventilation 39 (34.8%) 53 (45.2%) 0.65 (0.37–1.14) 0.106 Gastrointestinal bleed 30 (26.8%) 34 (29.1%) 0.89 (0.48–1.66) 0.701

Mean (range) dose of benzodiazepine used (mg/kg/day) 0.98 (0.50–1.46) 0.89 (0.44–1.47) 0.482 Mean (range) dose of pipecuronium used (mg/kg/day) 0.41 (0.04–1.08) 0.59 (0.20–0.97) 0.818 Stress ulcer prophylaxis given 26 (23.2%) 28 (23.9%) 0.96 (0.50–1.85) 0.898

Mean (range) duration in hospital (days) 27 (3–121) 29 (3–108) 0.468

Data are number (%) unless otherwise indicated.

ICU: intensive care unit.

ventilatedpatientsonageneralICUwererandomisedto

nursinginasemi-recumbent(45◦)versusasupineposition

reducedthefrequencyofHCAPfrom34%to8%(p=0.003)

andmicrobiologicallyconfirmedpneumoniafrom23%to

5%(p=0.018).15Thisstudy,whichwasstoppedbeforethe

plannedsamplesizehadbeenreached,showedthatsupine

bodyposition,enteralnutrition,mechanicalventilationfor

7daysor moreand aGlasgowComaScoreof lessthan

9wereindependentriskfactorsforHCAP.Asubsequent

randomised trial comparingnursing ventilated patients

ata45◦semi-recumbentpositionversus10◦ inthe

con-trolgroupfailedtopreventthedevelopmentofVAP.16In

thatstudy, inwhich bed elevationwasmonitoredby a

transducerwithpendulum,itwasobservedthatitproved

impossibletomaintainthetargetedbackrestelevationof

45◦forsemi-recumbentpositioningandthemeanachieved

treatmentpositionwas28◦

Theoropharynxofpatientswhohaveatracheostomyor

whoaremechanicallyventilated,rapidlybecomecolonised

with an abnormal bacterial flora, particularly

Gram-negativebacteria.Refluxofcolonisedgastriccontentsinto

theoropharynxprobablycontributestothisprocess

Sub-sequentaspirationoftheseorganismsintotherespiratory

tractis suggested to be partof the pathogenicprocess

leadingtoHCAP.Studieswithradioactivelylabelledgastric

contentsindicatethatpositioningventilatedpatientsina

semi-recumbentpositionreducesrefluxintothe

orophar-ynxandsubsequentaspirationintothelung.17,18 Thisis

therationalefornursingpatientsinthesemi-recumbent

position.Itispossiblethatthepathogenesisof

pneumo-niain tetanuspatientsmaydiffer fromotherventilated

patients.Ofnoteallpatientsinthisstudywhodeveloped

HCAPhadatracheostomy,whereas intheotherstudies

thepatientswereintubatedviatheoralroute.14–16Reflux

of gastriccontents intotheoropharynx andsubsequent aspiration intothe lung may bea less important route

by which pneumonia develops on patients with a tra-cheostomyandexogenousinfectionviathetracheostomy maybemoreimportantthanendogenousinfectionfrom theoropharynx.19Ofnote,patientsinthissettinghad a surgicaltracheostomyratherthanthepercutaneous(PERC) tracheostomiesmorecommonlyusedinICUsindeveloped countries

The30◦anglemaybeinsufficienttopreventthereflux

of gastriccontents intotheoropharynx andsubsequent aspirationintothelung.InthestudyofDrakulovic15the patientsweresemi-recumbentat45◦whereasinthestudy

ofvanNieuwenhoven16itprovedimpossibletomaintain theplannedangle45◦,anaveragetreatmentpositionof28◦

wastheresultonday1andwasdownto23◦byday7.15,16

Inthecurrentstudyweaimedfora30◦angleandthiswas checkedtwicedaily.Itwasnotedthatpatientstendedto slipdownthebedandthatitwasdifficulttomaintainthe

30◦elevation.Alimitationofthisstudyisthatwedidnot formallydocumenttheadherencetotheintendeddegree

ofelevation.Ithasalsobeensuggestedthatmaintaining

asupinepositioninthecontrolgroupasinthestudyof Drakulovic15ledtoahigherthannormalrateofHCAPthan

isthecaseifasmaller10◦angleismaintainedasinthe studyofvanNieuwenhoven.16

TherateofHCAPinthis studywas38–39/1000 ven-tilateddays Thisrateis highcompared withdeveloped countrysettingsbutwithintherangereportedin mechan-ically ventilatedpatientsindevelopingcountries.20–22 It waslowerthanwehadexpectedbasedonpreviousward experience In the period leading up to the study sev-eralchanges weremadein thewardinfrastructure and nursingcaretoimproveinfectioncontrol.Thismayhave contributedtothelowerpneumoniafrequencyduringthe courseofthestudy.Thestudysizeasaresult,lacked ade-quate powerto show the50% reduction in pneumonia

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analysis,therewasnosuggestionofalowerpneumonia

frequencyinthesemi-recumbentpatients

The development of pneumonia was independently

associated with an older age and a longer duration of

mechanical ventilation consistent withother studies of

pneumoniainpatientsreceivingmechanicalventilation.14

We used a blindnon-directedbronchial lavagemethod

with quantitative cultures to determine the organism

causing pneumonia.12 This method was appropriate

for the local situation and gave a range of

organ-isms consistent withstudies of VAP from othersimilar

locations.21–23

Mortalityinthis studywasindependently associated

witholderage,currentorpreviousinjectingdrugmisuse

andthepresenceofautonomicinstability.Olderageisa

wellrecognizedriskfactorformortalityintheseriouslyill

andthepresenceofautonomicinstabilityariskfactorfor

mortalityinpatientswithseveretetanus.2,4,5,24The

asso-ciationwithinjectingdrugusersislikelytoberelatedto

theincreasedmortalityintetanusassociatedwith

intra-muscular injections.25In this groupofpatients, theTTS

providedagoodpredictorofmortality.Themortalityrate

wasslightly higher in thepatientsmanaged ina

semi-recumbentpositionbutthiswasnotanindependentrisk

factorformortalityinmultivariateanalysisalthoughthe

studywasnotpoweredtolookatthisoutcome.The

over-all complicationrate,and the needfor a tracheostomy,

wassignificantlygreaterinthesemi-recumbentpatients

comparedwiththoseinthesupinepositiondespitesimilar

admissioncharacteristics.Theneedformechanical

ventila-tion,hypotensionandautonomicinstabilityalsooccurred

morefrequentlyinthesemi-recumbentgroupbutthe

dif-ferenceswerenotsignificant

5 Conclusion

Insummary,thisstudysuggeststhatnursingpatients

withseveretetanusina semi-recumbentpositionatan

elevation of 30◦ does not prevent the development of

HCAP Thisresultis likely tobegeneralisable tosevere

tetanuspatientsmanagedinother similarlocationsbut

not necessarilytotetanuspatientsmanagedina

devel-opedcountryICUortogeneralICUpatients.Alternative

strategies areneeded topreventpneumonia inpatients

withseveretetanus

Authors’contributions: HTL,JP,NTNN,LMY,JJFandCMP

conceived thestudyandwrotetheprotocol;allauthors

participatedintheconductofthestudy;NTNN,LMY,NTB,

TTDT,NMD,JIC,LTandCMPcontributedtodata

interpre-tationandanalysis;CMPwrotethefirstdraftofthepaper

Allauthorsreadandrevisedthemanuscriptandapproved

thefinalversion.CMPandJJFareguarantorsofthepaper

Acknowledgements: Wethankthehospitalleadersatthe

HospitalforTropicalDiseases(HoChiMinhCity,Vietnam)

fortheirsupportofthisworkandthestaffofthetetanus

wardandthemicrobiologylaboratoryfortheirhelpwith

theconductofthisstudy

Funding: ThestudywasfundedbytheWellcomeTrustof GreatBritain(grantreference089276/Z/09/Z).Thestudy sponsorshad noroleinthestudydesign,thecollection, analysis,orinterpretationofthedata,thewritingofthe report,orthedecisiontosubmitthepaperforpublication Competinginterests: Nonedeclared

Ethicalclearance: TheScientificand EthicalCommittee

oftheHospitalfor TropicalDiseases(HoChiMinh City, Vietnam) approved the study Informed verbal consent wasobtainedbeforeentryintothestudyfromthepatient

or their relatives if the patient couldnot provide con-sent.ThestudywasconductedincompliancewiththeICH andDeclarationofHelsinkiGuidelinesandwasregistered

onaclinicaltrialsdatabase(ClinicalTrials.govIdentifier: NCT01331252)

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