Does Re-intubation Increased Risk of Ventilator- Associated Pneumonia (VAP) in Pediatric Intensive Care Unit Patients?

Introduction:ventilator associated pneumonia(VAP),as defined by the centers for disease control and prevention (CDC),is a pneumonia that occurs in a patient receiving mechanical ventilation that develops 48 hours or more after initiation of ventilation.reintubation which occur within 72 hours of planned extubation may effect VAP incidence.the aim of this study was to determine VAP incidence in reintubated patients in comparision with patients underwent intubation without reintubation to highlight reintubation as a risk factor for VAP .Methods and materials: 1230 intubated patients ,admitted to PICU department were enrolled in this cohort observational study consecutively from may 2010 to may 2014.VAP was clinically suggested and confirmed by chest xray .patients demographic data,underlying disease,duration of mechanical ventilationlength of picu stayand reintubations were recorded prospectively. This study was approved by the institute,s ethics committee.Results: 336 intubated patients out of 1230 patients admitted to PICU department developed VAP(27%) with higher incidence in reintubated patients(30% vs 12%).Conclusion: VAP developed in nearly one third of intubated patients in our study.reintubation was significant risk factor for development of VAP.