شيوع، عوارض و عوامل مستعد كننده پنوموني وابسته به ونتيلاتور در بيمارستان سينا،تهران 1382

Prevalence, Complications and Risk Factors of Ventilator-Associated Pneumonia

Background and objective: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in the ICU, which is associated with a high mortality rate. The purpose of this study was to define the prevalence, risk factors and outcome of such infection in order to evaluate the therapeutic and interventional managements and also to monitor the hospital acquired nosocomial infection control system. Material and methods: This prospective cross sectional study was conducted on the patients intubated during their stay in the surgical ICU of Sina Hospital in 2003, following different types of surgeries. The patients were visited at regular times and CBC, blood and tracheal aspirate culture and chest X- Ray was performed in those suspected to pneumonia infection, VAP was the definite diagnosis in those who fulfilled the diagnostic criteria for pneumonia. Results: VAP was determined in 14 patients (17.5%) of the total 80 patients enrolled in the current study. Upper abdominal operation was performed in 35.7% of the infected and 24.2% of the non infected patients. In these patients, mechanical ventilation was required for 16.6 and 9.1 days, respectively. Re intubation was documented in 28.5% and 7.5% of the infected and non-infected cases, respectively. Mortality rate was reported to be 50% and 16.6%). Conclusion: Reintubation, prolonged intubation and upper abdominal surgery were the most important predisposing factors regarding to the high mortality rate of the present study.