An Observational Study on Intensive Care Unit Prophylaxis and Its Outcome in a Rural Tertiary Care Hospital | Chapter 8 | Technological Innovation in Pharmaceutical Research Vol. 10

 Background: The Intensive Care Unit (ICU) is utilised to treat critically ill patients closer to their beds so that they can be observed as individuals rather than numbers.

The purpose of this study is to look at the results of preventative treatments adopted to avoid stress ulcers, urinary tract infections, pressure ulcers, and chest infections in critically ill ICU patients.

Methods: One hundred admitted patients in the ICU, 25 each set of patients observed their prophylactic management to prevent stress ulcers, pressure ulcers, urinary tract infections, and chest infections, observations recorded for seven days, directly by looking at and cross-checking patient case sheets.

Results: Two patients (8%) acquired stress ulcers, one (4%) developed catheter-associated bacteriuria, two (8%) patients developed grade II pressure ulcers, and five (20%) patients underwent endotracheal intubation. All five (20%) sputum culture reports found Pseudomonas aeruginosa and Klebsiella susceptible to Ceftriaxone + Sulbactum. The conventional nursing care provided by on-duty nursing staffs, i.e., no one was given Ryle's tube feeding for stress ulcer cases, recommended a soft, pleasant, non-spicy oral diet. Patients with pressure ulcers were placed onto an air-bed mattress, the ulcers were cleansed with a soft-napkin bathed in normal water, and a sterile pad compressed dressing was applied locally. Endotracheal tube cleansed 8-12 times within 12 hours for ventilator in-situ patients. Before utilising the ventilator, clean the inbuilt ventilator tube, change the filter, and keep it ready by following the basic aseptic precautions. All five ventilated patients received chest physiotherapy from a chest medicine specialist. Injection Pantoprazole 40mg once daily, Injection Ciprofloxacin 400mg twice daily, and Injection Ceftriaxone + Sulbactum gm 12 hours interval supplied daily as prophylactic therapy.

To avoid stress ulcers, standard nursing care was used as the primary intervention in the Intensive Care Unit, along with injection Pantoprazole 40mg once day. Ciprofloxacin 400mg injection used twice day to prevent Catheter-Associated Bacteriuria. To prevent Ventilator Associate Pneumonia and pressure ulcers, a 1 gm injection of Ceftriaxone + Sulbactum is given every 12 hours. 12 hourly injection of Ceftriaxone + Sulbactum 1gm Prophylactic interventions in the Intensive Care Unit helped to prevent future complications and lowered morbidity.

Author (S) Details

P. Vijai Ananth
Department of General Medicine, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamilnadu, India.

Surendra Kumar Bouddh
Department of Pharmacology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamilnadu, India.

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