BackgroundTracheal aspiration of gastric content among mechanically ventilated and tube-fed critically ill patients is of great concern. The mechanism leading to bacterial colonization of the lower respiratory tract in mechanically ventilated patients is tracheal aspiration of oral or gastric contents leading to Ventilator Associated Pneumonia (VAP). VAP is the most common nosocomial infection in the Intensive Care Unit (ICU). ICU-VAP generates about half of the cases of hospital-acquired pneumonia. There are various nursing practices available to reduce the rate of aspiration, but their efficacy is limited and they are not strong enough to prevent aspiration and VAP in practice. In this clinical study we used the smARTrack System, by ART MEDICAL, to assess the frequency of gastro-esophageal reflux in 20 ventilated ICU patients and its' correlation to procedures during routine patient care. MethodsThe smARTrack System is comprised of a novel gastric tube and an electronic monitoring console, which contains the system's software. The tube contains a series of bio-impedance sensors that can detect the presence of fluid around them. We conducted a study on 20 ICU ventilated patients at the Rambam Health Care Campus in Haifa, Israel. Reflux events and their duration were recorded when the tube detected gastric content rising above the sensors located at the lower esophageal sphincterResultsOur main findings shows that gastro-esophageal reflux occurs on average three times per hour of mechanical ventilation. We have also recorded three common clinical scenarios that were associated with a high risk of reflux; patient position-change, enteral fluid bolus, tracheal suction and migration of the feeding tube tip during ongoing use. ConclusionsGasto-esophageal reflux is a common event in the ICU as shown by the smARTrack System and may be related to routine patient care procedures. This study provides an important insight into the consequences of these procedures and might suggest ways to further improve them in reducing the rate of gasto-esophageal reflux and the risk of VAP among mechanicaly ventilated ICU patients.https://clinicaltrials.gov/ct2/show/NCT02705781?term=smARTrack&draw=2&rank=1 registered 11.3.2016
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