Differences in glucose concentrations of tracheal secretions, feeding methods, and patients’ features between formula aspiration group and non-aspiration group

초록

The purpose of this study is to investigate differences in glucose concentrations of tracheal secretions by measurement times, feeding methods, and clients’ characteristics between formula aspiration group and non-aspiration group. The subjects for this study were 36 critically ill patients receiving nasogastric tubes feeding in SICU and MICU. Tracheal secretions were collected via ET tube or tracheostomy tube three times per a day for 2 days. Collected secretions were tested for glucose concentration using Accucheck II glucometer. Overall subjects were divided into two groups(aspiration and non-aspiration). Aspiration group should satisfy all three criteria. Criteria are as follows: when 1) more than one tracheal secretion of six specimens was measured as over 20mg/dl in glucose concentration.; 2) one or more signs of systemic inflammation was combined; 3) one or more signs of respiratory deterioration was combined. Subjects were 18(50%) males and 18(50%) females. Consciousness levels of subjects were alert/drowsy (14), stuporous (12), and semi (coma)/sedated (10). Mean ages of them was 59.53 years old. Differences between the two groups were not significant. There was not significant difference in diabetes. The glucose concentration of specimens increased more and more with time progress. Specimens collected between an hour and two hours after feeding were significantly different between the two groups. There was significant difference in tube feeding methods. In conclusion, to maintain (semi)fowler’s position or head up position for 30 minutes after feeding is may not enough time to prevent pulmonary aspiration. Nurses should not give formula using syringes anymore, rather should provide slowly using gravity to prevent pulmonary aspiration.