Physiological changes associated with routine nursing procedures in critically ill are common: an observational pilot study

Abstract

In this pilot study, we examined physiological changes in connection with all regular routine nursing procedures in the ICU. We found that physiological changes were common and sometimes severe.

The importance of being meticulous in evaluating the evidence and risks with everyday care

“…In this perspective we find the study by Engström et al ,. recently published in this journal, to be of particular interest.…”

“…In conclusion, studies of ICU routine procedures in terms of potential benefits and possible harm are strongly advocated, such as this small pilot observational study, which could identify frequent incidents in terms of changes in physiological variables in association with everyday nursing procedures. Proper evidence for the benefit and possible harm will be necessary to improve quality in care and to improve outcomes.…”

Automated vs. conventional ventilation in the ICU: a randomized controlled crossover trial comparing blood oxygen saturation during daily nursing procedures (I-NURSING)

“…Based on previous studies on DNPs [9,10] and retrospective data collected in our institution, we estimated that patients spent 40% of the DNP duration with SpO 2 between 90 and 95%. We calculated a sample size of 267 patients by group to detect a 15% increase in the primary outcome for DNPs performed in AV as compared to CV (2-sided α = 0.05; power 80%).…”

“…However, these DNPs induce physiological changes with potential adverse effects, especially in patients undergoing mechanical ventilation (MV) [5][6][7][8][9]. Respiratory events, in particular oxygen desaturation, are often observed during DNPs but are not well documented [10]. Although the potential adverse effects may be serious (e.g., severe hypoxemia and cardiac arrest), these events are often downplayed, considered as a normal part of DNPs, or ignored in interventional studies regarding MV in ICU patients [10].…”

“…Respiratory events, in particular oxygen desaturation, are often observed during DNPs but are not well documented [10]. Although the potential adverse effects may be serious (e.g., severe hypoxemia and cardiac arrest), these events are often downplayed, considered as a normal part of DNPs, or ignored in interventional studies regarding MV in ICU patients [10]. As suggested by previous works, protocols should be developed to prevent such respiratory events [11,12].…”