Hospital Acquired and Ventilator Associated Pneumonia
Abstract
The aim of study. To determine the incidence of Ventilator Associated Pneumonia (VAP) in the patients undergoing mechanical ventilation and to determine the predisposing factors of VAP after tracheotomy. Materials and methods. A retrospective study in 135 patients undergoing mechanical ventilation. During the study period (2010-2011). The study is conducted in the surgical and medical intensive care unit. At the time of entry, age, smoking history, history of the chronic obstructive pulmonary disease (COPD), indication for a mechanical ventilator, the Acute Physiology and Chronic Health Evaluation (APACHEII) score (11) were recorded daily. Results. The Patients that are included in our study were 135 patients, 95 men, and 40 women with a mean age of 64.0 ± 14.6 years. Mainly diagnosis that patients were admitted in intensive care unit (ICU); COPD in (n=32), neurological disorders (n=31) of COPD (n=46). Diagnosed by VAP were 32 patients (25%) of the 135 patients. A logistic regression model used to evaluate the effect of several factors on outcome. The presence of hyperthermia > 38 and duration with sedation [odd ratio (OR) 6.69; 4.25, 95% CI (Confidence Interval), P< 0.001; P< 0.005]. Conclusion: We conclude that it is very important giving the appropriate prophylactic antibiotic therapy especially for patients after tracheotomy, decreasing in this way the possibility of VAP. That‘s why we have to know who are the most frequently identified responsible pathogens in the unit; have to be informed of pulmonary secretions, the effects and characteristic of antibiotics for treating of VAP. [3,4,5]. Tracheotomy is a predisposing factor for VAP. Using bronchoscopy before doing tracheotomy decrease the incidence of VAP. Is important doing the microbiological analysis for determining the diagnose of infections? The accuracy of initial antibiotic has a great impact on survival.
Keywords: mechanical ventilation, ventilator acquired pneumonia, tracheostomy.
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