SavedAdd your journal

Journals / Anestezi Dergisi / 2002 / Cilt: 10 - Sayı: 3

Ventilator-associated nosocomial pneumonia cases

Mekanik ventilasyona bağlı gelişen nozokomiyal pnömoni olgularımız

Meyancı Güniz KÖKSAL
HÜSEYİN ÖZ
Pages
217–221
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In conclusion, in our ICU, polymicrobial agents were mostly the ethiologic factor in cases diagnosed to have VAP.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:The aim of this study was to designate the incidence, pathogens and mortality of ventilator-associated pneumonia (VAP) cases in Emergency Intensive Care Unit (EICU).
📊
Key Findings & Data:Between 1 January 1999-31 Novamber 2001, 82 out of 102 cases who were ventilated for more than 3 days and diagnosed to have VAP were included in the study.
💡
Conclusion & Impact:In conclusion, in our ICU, polymicrobial agents were mostly the ethiologic factor in cases diagnosed to have VAP.
🔬Design:Research Article
📍Scope:2001 Verileri
⚙️Variables:Ölüm oranı · Solunum · yapay

Abstract

The aim of this study was to designate the incidence, pathogens and mortality of ventilator-associated pneumonia (VAP) cases in Emergency Intensive Care Unit (EICU). Between 1 January 1999-31 Novamber 2001, 82 out of 102 cases who were ventilated for more than 3 days and diagnosed to have VAP were included in the study. In all cases routine ECG, invasive and noninvasive blood pressure, central venous pressure (CVP), body temperature recordings and urine culture, microbiological analysis of endotracheal aspirates, chest x-ray were obtained. Antibiotherapy of the cases were scheduled according to antibiogram results in double and triple fashion. VAP incidence was found to be 79.4% and mortality as 64.2%. Microbiological culture results of the endotracheal aspirate revealed MRSA in 9 cases (11%), A.baumannii in 9 cases (11%), P. aeruginosa in 8 cases (9.9%), Enterobacter spp in 6 cases (7.4%), C. albicans in 4 cases (%4.9), E.coli in 2 cases (2.5%), Citrobacter in 1 case (1.2%), H.influenza in 1 case (1.2%) and whereas in 49 cases (50.6%) it was polymicrobial. In conclusion, in our ICU, polymicrobial agents were mostly the ethiologic factor in cases diagnosed to have VAP. Although VAP incidence in our ICU was found to be higher, the mortality was in acceptable range when compared with the results in literature.

Özet

Retrospektif olarak yaptığımız çalışmamızda, yoğun bakım ünitemizdeki ventilatöre bağlı gelişen pnömoni (VAP) insidansını, etkenlerini ve mortalitemizi belirlemeyi amaçladık. Çalışmaya 1 Ocak 1999 ile 31 Kasım 2001 tarihleri arasında, en az 3 gün süre ile mekanik ventilasyon uyguladığımız 102 olgudan VAP gelişen 81 tanesi dahil edildi. Olgularımızda rutin olarak EKG, invaziv-noninvaziv arter basıncı, santral ven basıncı, vücut ısısı, hemotokrit, hemoglobin, lökosit, trombosit, elektrolitler (Na+2, K+,Cat+2, Cl-), hemokültür, idrar kültürü, endotrakeal aspiratların 72 saat aralıklar ile mikrobiyolojik analizleri, akciğer grafileri izlendi. APACHE II skoru kullanıldı. Olgularımıza antibiyotik tedavisi kültür antibiyogram sonuçları göz önüne alınarak ikili veya üçlü kombinasyonlar halinde düzenlendi. Pnömoni insidansımızı %79.4, mortalitemizi %64.2 olarak saptadık. Endotrakeal aspiratların mikrobiyolojik analizlerinde, olgularımızın 49'unda (%50.6) polimikrobiyal, 9'unda (%11 ) Metisiline rezistant staphylococcus aureus, 9'unda (%11) Acinetobacter baumannii, 8'inde (%9.9) Pseodumonas aeruginosa, 6'sında (%7.4) Enterobacter spp, 4'ünde (%4.9) Candida albicans, 2'sinde (%2.5) Escherichia Coli, 1'inde (%1.2) Citrobacter, 1'inde (%1.2) Haemophilus influenza etkenleri saptanmıştır. Sonuç olarak, yoğun bakım ünitemizde mekanik ventilasyona bağlı gelişen pnömonilerin yarısı, polimikrobiyal etkenlerle oluşmaktadır. VAP insidansımız kaynak bilgilerine göre yüksek olmasına karşın, mortalitemiz kabul edilebilir düzeylerdedir

🔖

Cite This Article

KÖKSAL, M. G., ÖZ, H. (2002). Ventilator-associated nosocomial pneumonia cases. Anestezi Dergisi, Cilt: 10 - Sayı: 3, 217–221. https://ajindex.com/articles/355298

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (15)

  1. İbrahim EH, Sherman G, Ward S, Fraser VJ, Roller MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patients in the ICU setting. Chest 2000; 118: 146-255
  2. Bregeon F, Ciais V, Carrel V, et al. Is ventilator-associated pneumonia an independent risk factor for death? Anesthesiology 2001;94:554-60
  3. Ruiz M, Torres A, Ewig S, et al: Noninvasive versus invasive microbial investigation in ventilator-associated pneumonia. Evaluation of ouicome. Am J Respir Crit Care Med 2000; 162; 119-25
  4. Celis R, Torres A, Gatell JM, et al. Nosocomial pneumonia: in multi variance analysis of risk and prognosis. Chest 1988; 93; 318-24
  5. Heyland DK, Cook DJ, Griffith L, Keenan SP, Brun-Buisson C. The attributable morbidity and mortality of ventilator-associated pneumonia in the critical ill patient: The Canadian Critical Trials Group. Am J Respir Crit Care Med 1999; 159: 1249-56
  6. Crave DE, Kunches LM. Risk factors for pneumonia and fatality in patients receiving continous mechanical ventilation. Am J Respir Dis l986; 133:789-92
  7. Marik EP, Careaw P. The role of anaerobes in patients with ventilator-associated pneumonia and aspiration pneumonia. Chest 1999; 115: 178-83
  8. Garcia JL, Leyba CO, Montcro JG, et al. Mortality and the increase in length of stay attributable to the acquisition of Acinetobacter in critically ill patients. Crit Care Med 1999; 27 (9): 1794-9
  9. Pingleton SK, Fagon JY, Leeper K V. Patients selection for clinical investigation of ventilator-associated pneumonia: Criteria for evaluating diagnostic technique. Chest [992;102 (suppl): 553-6
  10. Baron EJ, Peterson LR, Finegold SM. Bailey and Scott's diagnostic microbiology, 9th ed. St Louis. Co Mosby Co 1994: 474-9
  11. Barlett JG, O'Keefe P. Bacteriology of hospital acquirred pneumonia. Arch Intern Med 1986; İ46: S62-8
  12. Campell GD Jr. Blinded invasive diagnostic procedures in ventilator-associated pneumonia. Chest 2000; 117: 2073-119
  13. Blot F, Raynard B, Chachaty E, Tancrede C, Antoun S, Nitenberg G. Value of gram stain examination of lower respiratory tract secretions for early diagnosis of nosocomial pneumonia. Am J Respir Crit Care Med 2000; 162: 1731-7
  14. Timsit JF, Misset B, Azoulay E, et al. Usefulness of airway visualization in the diagnosis of nosocomial pneumonia in ventilated patients. Chest 1996; 110: 172-9
  15. Peerless JR, Snow N, Likavec MJ, Pinchak AC, Malangoni MA. The effect of fiberoptic bronchoscopy on cerebral hemodynamics in patien