Head-of-Bed Elevation and Early Outcomes of Gastric Reflux, Aspiration and Pressure Ulcers: A Feasibility Study

Schallom, Marilyn; Dykeman, Betsy; Metheny, Norma A.; Kirby, John D.; Pierce, Janet D.

doi:10.4037/ajcc2015781

Cited by 27 publications

(19 citation statements)

References 48 publications

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“…NPUAP also recommends that an individual not be positioned directly on a pressure ulcer 32 . Schallom and colleagues 33 have compared research to prevent aspiration and pressure ulcers in critically ill patients and suggest that the optimal elevation to balance the risks for both of these issues is unknown. They recommend that until more evidence is available, caregivers should make HOB elevation decisions in the context of the patient's overall condition.…”

Section: Section 6 Administration: Generalmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

330

531

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Enteral nutrition (EN) is a valuable clinical intervention for patients of all ages in a variety of care settings. Along with its many outcome benefits come the potential for adverse effects. These safety issues are the result of clinical complications and of process-related errors. The latter can occur at any step from patient assessment, prescribing, and order review, to product selection, labeling, and administration. To maximize the benefits of EN while minimizing adverse events requires that a systematic approach of care be in place. This includes open communication, standardization, and incorporation of best practices into the EN process. This document provides recommendations based on the available evidence and expert consensus for safe practices, across each step of the process, for all those involved in caring for patients receiving EN.

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Section: Section 6 Administration: Generalmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

330

531

View full text Add to dashboard Cite

show abstract

“…Three studies examined the effectiveness of a variety of patient positioning strategies and the impact on PU development (Girard et al., ; Schallom, Dykeman, Metheny, Kirby, & Pierce, ; Van Nieuwenhoven et al., ). Strategies evaluated were diverse: one study compared the effectiveness of the backrest elevation of 28° versus 10° for semirecumbent positioning with findings revealing no differences between each position (28° vs. 10°) groups in developing HAPUs (28% vs. 30% respectively; Van Nieuwenhoven et al., ).…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review

Tayyib¹,

Coyer

2016

Worldviews Ev Based Nurs

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Background: Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention.

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“…CD40L is rapidly presented on the platelet surface after stimulation and is subsequently cleaved from the surface to generate soluble fragments that play a key roles in the inflammatory response [48]. Also, the translocation of CD40L coincides with the release of platelet-derived growth factor, transforming growth factor beta (TGF-β), platelet-factor 4 (PF4), and thrombospondin from a-granules [49]. …”

Section: Resultsmentioning

confidence: 99%

Gingipains: Critical Factors in the Development of Aspiration Pneumonia Caused by <b><i>Porphyromonas gingivalis</i></b>

Benedyk¹,

Mydel

Delaleu

et al. 2015

J Innate Immun

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Aspiration pneumonia is a life-threatening infectious disease often caused by oral anaerobic and periodontal pathogens such as Porphyromonas gingivalis. This organism produces proteolytic enzymes, known as gingipains, which manipulate innate immune responses and promote chronic inflammation. Here, we challenged mice with P. gingivalis W83 and examined the role of gingipains in bronchopneumonia, lung abscess formation, and inflammatory responses. Although gingipains were not required for P. gingivalis colonization and survival in the lungs, they were essential for manifestation of clinical symptoms and infection-related mortality. Pathologies caused by wild-type (WT) P. gingivalis W83, including hemorrhage, necrosis, and neutrophil infiltration, were absent from lungs infected with gingipain-null isogenic strains or WT bacteria preincubated with gingipain-specific inhibitors. Damage to lung tissue correlated with systemic inflammatory responses, as manifested by elevated levels of TNF, IL-6, IL-17, and C-reactive protein. These effects were unequivocally dependent on gingipain activity. Gingipain activity was also implicated in the observed increase in IL-17 in lung tissues. Furthermore, gingipains increased platelet counts in the blood and activated platelets in the lungs. Arginine-specific gingipains made a greater contribution to P. gingivalis-related morbidity and mortality than lysine-specific gingipains. Thus, inhibition of gingipain may be a useful adjunct treatment for P. gingivalis-mediated aspiration pneumonia.

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Head-of-Bed Elevation and Early Outcomes of Gastric Reflux, Aspiration and Pressure Ulcers: A Feasibility Study

Cited by 27 publications

References 48 publications

ASPEN Safe Practices for Enteral Nutrition Therapy

ASPEN Safe Practices for Enteral Nutrition Therapy

Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review

Gingipains: Critical Factors in the Development of Aspiration Pneumonia Caused by <b><i>Porphyromonas gingivalis</i></b>

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