Clinical Outcomes of Implementing Two Management Protocols for Acute Respiratory Distress Patients with COVID-19: A Randomized Controlled Trial
Talaat Ahmed, A., Atiaa Tolba, A., Abdel Khalek Abou glala, A., Ismael Abdelhafez, A., Abdelnasser Mohamed, A., Abdellateif Mohamed, Z., Aly Mahgoub, A. (2022). Clinical Outcomes of Implementing Two Management Protocols for Acute Respiratory Distress Patients with COVID-19: A Randomized Controlled Trial. EKB Journal Management System, 13(2), 2165-2177. doi: 10.21608/ejhc.2022.311749
Ahmed Talaat Ahmed; Asmaa Atiaa Tolba; Ayman Abdel Khalek Abou glala; Amal Ismael Abdelhafez; Amal Abdelnasser Mohamed; Zienab Abdellateif Mohamed; Asmaa Aly Mahgoub. "Clinical Outcomes of Implementing Two Management Protocols for Acute Respiratory Distress Patients with COVID-19: A Randomized Controlled Trial". EKB Journal Management System, 13, 2, 2022, 2165-2177. doi: 10.21608/ejhc.2022.311749
Talaat Ahmed, A., Atiaa Tolba, A., Abdel Khalek Abou glala, A., Ismael Abdelhafez, A., Abdelnasser Mohamed, A., Abdellateif Mohamed, Z., Aly Mahgoub, A. (2022). 'Clinical Outcomes of Implementing Two Management Protocols for Acute Respiratory Distress Patients with COVID-19: A Randomized Controlled Trial', EKB Journal Management System, 13(2), pp. 2165-2177. doi: 10.21608/ejhc.2022.311749
Talaat Ahmed, A., Atiaa Tolba, A., Abdel Khalek Abou glala, A., Ismael Abdelhafez, A., Abdelnasser Mohamed, A., Abdellateif Mohamed, Z., Aly Mahgoub, A. Clinical Outcomes of Implementing Two Management Protocols for Acute Respiratory Distress Patients with COVID-19: A Randomized Controlled Trial. EKB Journal Management System, 2022; 13(2): 2165-2177. doi: 10.21608/ejhc.2022.311749

Clinical Outcomes of Implementing Two Management Protocols for Acute Respiratory Distress Patients with COVID-19: A Randomized Controlled Trial

Egyptian Journal of Health Care
Volume 13, Issue 2, June 2022, Page 2165-2177  XML PDF (343.47 K)
Document Type: Original Article
DOI: 10.21608/ejhc.2022.311749
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Authors
Ahmed Talaat Ahmed1; Asmaa Atiaa Tolba2; Ayman Abdel Khalek Abou glala1; Amal Ismael Abdelhafez3; Amal Abdelnasser Mohamed4; Zienab Abdellateif Mohamed5; Asmaa Aly Mahgoub6
1Lecturer, Anesthesia and intensive care department, Faculty of Medicine, Assiut University, Assiut, Egypt,
2Lecturer, Critical Care and emergency nursing department, Faculty of Nursing, Assiut University, Assiut, Egypt,
3Assistant professor, Critical care and emergency nursing department, Faculty of Nursing, Assiut University, Assiut, Egypt,
4Lecturer, Medical surgical nursing (critical care nursing) Department, Faculty of nursing, Badr University, Assiut, Egypt,
5Professor, Medical surgical nursing department, Faculty of nursing, Badr University, Assiut, Egypt,
6Assistant professor, Critical Care and emergency nursing department, Faculty of Nursing, Assiut University, Assiut, Egypt.
Abstract
Background: Acute respiratory distress syndrome (ARDS) patients with COVID-19 require sedation or neuromuscular blocking agents to facilitate mechanical ventilation. Aim: to assess the effect of two management protocols on the clinical outcomes of ARDS patients with COVID-19. Research design: This randomized controlled trial included 80 patients with COVID-19 admitted in intensive care units of main hospital Assiut University in Egypt. Sample: A purposive sample was collected according to inclusion criteria. Tools: four tools were included in this study. Methods: ICU nurses and the researchers evaluated the clinical outcomes of administer sedatives versus muscle relaxant protocols among ARDS patients with COVID-19. Propanol and midazolam were used in the – sedatives protocol, and cisatracurium was used in the muscle relaxant protocol. The clinical outcome measures were oxygenation parameters, lung mechanics, tissue perfusion parameters, organ failure, success of weaning, and survival in 28 days. Results: More than two-thirds (67.5 %) of the sedation group were successfully weaned from mechanical ventilation from the first trial, while more than half (57.5 %) of the muscle relaxant group needed another trial for weaning, with a statistically significant difference between both groups. The mean duration of mechanical ventilation was not significantly between the muscle relaxant group (9.24± 5.66) and the sedation group (8.27 ± 3.91). Conclusion: Severe ARDS patients with COVID-19 who underwent the sedation protocol were successfully weaned from mechanical ventilation from the first attempt, compared to those who used muscle relaxants. Morality rate was significantly reduced by sedation compared to using muscle relaxant.
Keywords
ARDS; COVID-19; Muscle relaxant; Sedation
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