Journal of Holistic Nursing and Midwifery، جلد ۳۵، شماره ۳، صفحات ۰-۰

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عنوان انگلیسی The Effects of the ABCDE Bundle on the Hemodynamic Stability of Patients under Mechanical Ventilation
چکیده انگلیسی مقاله Introduction: The number of adult patients requiring mechanical ventilation in intensive care units is increasing every year. It is necessary to identify effective solutions to hemodynamic problems of mechanical ventilation.
Objective: The present study was designed to determine the effect of the ABCDE bundle (ABC: Awakening, Breathing, and Coordination, D: Delirium, Monitoring, E: Early mobility) on the hemodynamic stability of patients under mechanical ventilation.
Materials and Methods: The study is a two-group clinical trial. The research sample included 90 patients undergoing mechanical ventilation in an Intensive Care Unit (ICU), who were randomly assigned to the intervention and control groups by the block randomization method. The most important inclusion criteria were as follows: being 18-60 years old; suffering from subgroups of pulmonary diseases; and having a minimum duration of mechanical ventilation of 48 hours. The exclusion criterion was unwillingness to continue participation in research at any stage. In the intervention group, the ABCDE bundle was implemented in 7 days. Hemodynamic indicators, including Mean Arterial Pressure (MAP), Pulse Pressure (PP), and Heart Rate (HR), were measured on days 0, 1, 3, 5, and 7. In the control group, common sedation and pain relief were performed according to the routine of the ward. Repeated measures analysis of variance (ANOVA), independent t test, Chi-square test, and Mann-Whitney test were used for data analysis. P values less than 0.05 were considered statistically significant.
Results: Patients' mean ± SD ages were 48.76 ± 11.46 in the intervention group and 47.58 ± 11.56 years in the control group. In the ABCDE bundle group, MAP was stable on day 7 compared with day 0, but there was a statistically significant decrease in MAP in the control group (P<0.05). Also, in the intervention group, the PP increased and the HR decreased significantly (P=0.001). The results of the repeated measures ANOVA showed that the effects of time, group, and the interaction effect of time and group on the mean MAP and PP were significant (P = 0.001). Additionally, only the effect of group on the mean HR was significant (P=0.038).
Conclusion: It seems that the ABCDE bundle can improve hemodynamic indicators and be performed as an effective and accessible method by nurses.
کلیدواژه‌های انگلیسی مقاله Mechanical ventilation, Intensive care units, Breathing exercises, Delirium, Exercise

نویسندگان مقاله | Javad Malekzadeh
Instructor, Department of Medical Emergencies, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran


| Mahsa Ghouchani
Nursing (MSc.), Department of Critical Care Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran


| Ahmad Bagherimoghadam
Assistant Professor, Department of Anesthesiology, School of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Ira


| Tahere Sadeghi
Assistant Professor, Department of Pediatrics, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran


| Mohammad Rajabpour
Ph.D. Candidate of Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran



نشانی اینترنتی http://hnmj.gums.ac.ir/browse.php?a_code=A-10-1867-1&slc_lang=en&sid=1
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