呼吸机相关性肺炎的持续挑战:二级医院重症监护病房的流行病学、预防和死亡危险因素

IF 1.8 Q3 INFECTIOUS DISEASES
Cihan Semet
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引用次数: 0

摘要

背景:呼吸机相关性肺炎(VAP)是重症监护病房感染中发病率和死亡率的主要原因。尽管采取了各种预防措施,VAP的发病率仍然很高。目的:本研究旨在探讨二级护理医院VAP相关死亡率的流行病学和危险因素,比较实施VAP预防方案前后的结果。方法回顾性研究于2021年7月1日至2023年6月30日在一家二级护理医院进行。患者年龄超过18岁,机械通气时间超过48小时。该研究比较了实施VAP预防措施前后VAP的发病率、微生物病因学和结局,并分析了VAP死亡的危险因素。结果共纳入83例VAP患者。尽管采取了协调一致的措施来实施VAP预防措施,但每1000个呼吸机日的VAP率、早发性VAP、继发性血流感染、急性呼吸窘迫综合征和30天死亡率没有显著下降。VAP的微生物病因学在两个时期保持一致。淋巴细胞计数和白蛋白水平下降被确定为30天死亡率的独立危险因素。结论:在二级护理医院,实施VAP预防措施并没有显著降低VAP的发生率或改善VAP的预后。微生物病因学保持不变。监测淋巴细胞计数和白蛋白水平可能有助于确定高死亡风险的患者。需要进一步研究以制定更有效的VAP预防和管理策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The ongoing challenge of ventilator-associated pneumonia: epidemiology, prevention, and risk factors for mortality in a secondary care hospital intensive care unit

Background

Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality among intensive care unit infections. Despite various preventive measures, the incidence of VAP remains high.

Aims

This study aimed to explore the epidemiology and risk factors for VAP associated mortality in a secondary care hospital, comparing outcomes before and after implementing a VAP prevention bundle.

Methods

This retrospective study was conducted from July 1, 2021, to June 30, 2023, at a secondary care hospital. Patients over 18 years old who underwent mechanical ventilation for more than 48 hours were included. The study compared the incidence, microbiological etiology, and outcomes of VAP before and after implementing the VAP prevention bundle and analyzed risk factors for mortality from VAP.

Results

A total of 83 patients diagnosed with VAP were included. Despite concerted efforts to implement the VAP prevention bundle, there was no significant decrease in the VAP rate per 1000 ventilator days, early-onset VAP, secondary bloodstream infections, acute respiratory distress syndrome, and 30-day mortality. The microbiological etiology of VAP remained consistent between the two periods. A decrease in lymphocyte count and albumin level were identified as independent risk factors for 30-day mortality.

Conclusions

Concerted efforts to implement a VAP prevention bundle did not significantly reduce the incidence or improve outcomes of VAP in this secondary care hospital setting. The microbiological etiology remained unchanged. Monitoring lymphocyte count and albumin level may help identify patients at high mortality risk. Further research is needed to develop more effective VAP prevention and management strategies.

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来源期刊
Infection Prevention in Practice
Infection Prevention in Practice Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
0.00%
发文量
58
审稿时长
61 days
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