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. 2025 Feb;118(2):128-133.
doi: 10.14423/SMJ.0000000000001790.

ICU-Broncho-Aspiration Protocols Monitoring at an Academic Health Network System

Araceli Cuaranta, Michael Abdelmasseh, Calyb King  1 , Alex Ashley  1 , Jeremy Eckles  1 , Juan Hernandez-Pelcastre  1 , Tania Nguyen  1 , Nic Tate  1 , Chase Gillispie  1 , Joshua Keefer  1 , Levi Nolan  1 , Errington Thompson, Robert Finley, Barbara Payne, Alexei Gorka, Jonathan Willis, Vineela Kadiyala, Juan Sanabria
Affiliations

ICU-Broncho-Aspiration Protocols Monitoring at an Academic Health Network System

Araceli Cuaranta et al. South Med J. 2025 Feb.

Abstract

Objectives: The objectives were to determine intensive care unit (ICU) incidence of broncho-aspiration (BA) and the effect of monitoring BA prevention protocols.

Methods: The Health Network Warehouse was interrogated for the diagnosis of BA in patients older than 18 years in the surgical ICU (SICU) from January 2010 to December 2020. A BA prevention bundle protocol was prospectively monitored during all consecutive SICU admissions from August 2021 to November 2021 until discharge/death (n = 159). Experimental subjects were matched for age, sex, body mass index, and comorbidities with historical controls (BA- and BA+) as a propensity score analysis study. The BA prevention bundle protocol consisted of head-of-bed elevation at 30°, acid-suppressive medication, and daily administration of mouthwash. Univariate/multivariate analyses were conducted (P < 0.05).

Results: The BA incidence over a 10-year period was 5.6%. Before study initiation, random monitoring showed a mean bundle protocol compliance of 29% (18%-39%). After the introduction of protocol monitoring, compliance increased to 92% despite an upsurge in temporary nurses serving in the ICU. There was a total of 795 daily entries, with a mean head-of-bed elevation of 29.8° ± 13°, and a 10-fold decrease in BA (from 5.6% to 0.6%, P < 0.01).

Conclusions: Implementation and monitoring of a BA prevention protocol significantly reduced the rate of BA in the SICU.

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Figures

FIG
FIG
Forest analysis of predictive variables for broncho-aspiration and sepsis. Smoking was a significant predictor of BA. Smoking and surgical history were significant predictors of sepsis. CI, confidence interval; OR, odds ratio.
See this image and copyright information in PMC

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