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ISSN 1561-3054 (Electronic)

2020, Number 3

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Rev Cubana Med Trop 2020; 72 (3)

Respiratory ventilation and intubation as risk factors for pneumonia in a tertiary hospita

Roque-Roque JS, Pereira-Victorio CJ

Language: Spanish
References: 23
Page: 1-13
PDF size: 315.98 Kb.


ABSTRACT

Introduction: Healthcare-associated pneumonia worsens the clinical prognosis of patients and exerts economic pressure on health systems.
Objective: Determine the risk for healthcare-associated pneumonia among patients exposed to ventilation / intubation and other intrinsic and extrinsic factors.
Methods: An analytical cross-sectional study was conducted of the patients admitted to Adolfo Guevara Velazco National Hospital in Cusco in the year 2017. A sample was chosen which was composed of two groups: with and without a pneumonia diagnosis. The estimated sample size was 67 (15 in the pneumonia group and 52 in the non-pneumonia group). Inferential analysis was performed along two stages, using hypothesis contrast tests followed by logistic regression. Intrinsic and extrinsic factors were collected for each patient.
Results: Most patients were female (53.7%). Mean age was 70.6 years. The intensive care unit service had the highest proportion of cases (42.9%). A significant association was found with the use of ventilation/intubation, as well as with extrinsic factors such as tracheostomy, secretions aspiration, enteral nutrition and blood transfusion. None of the intrinsic factors had a significant association in the bivariate analysis. In the logistic regression analysis, patients subjected to ventilation/intubation had 5.27 times the risk of contracting pneumonia, whereas patients subjected to blood transfusion had 12.75 times the risk.
Conclusions: Patients exposed to ventilation/intubation were at greater risk of developing healthcare-associated pneumonia. Blood transfusion was another associated factor.


REFERENCES

  1. World Health Organization. Report on the burden of endemic health care-associated infection worldwide. World Health Organization. 2011?. [acceso: 05/03/2019]. Disponible en: Disponible en: https://apps.who.int/iris/handle/10665/80135

  2. Dámaso-Mata B, Chirinos-Cáceres J, Menacho-Villafuerte L. Estimación de costos económicos en la atención de la neumonía nosocomial en un hospital regional peruano, 2009 al 2011. Revista Peruana de Medicina Experimental y Salud Publica. Apr 2016;33(2):233-40.

  3. Cassini A, Plachouras D, Eckmanns T, Abu Sin M, Blank H-P, Ducomble T, et al. Burden of Six Healthcare-Associated Infections on European Population Health: Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study. PLoS Med. 2016;13(10).

  4. Celis R, Torres A, Gatell JM, Almela M, Rodríguez-Roisin R, Agustí-Vidal A. Nosocomial pneumonia. A multivariate analysis of risk and prognosis. Chest. 1988;93(2):318-24.

  5. Sopena N, Heras E, Casas I, Bechini J, Guasch I, Pedro-Botet ML, et al. Risk factors for hospital-acquired pneumonia outside the intensive care unit: a case-control study. Am J Infect Control. 2014;42(1):38-42.

  6. Centro Nacional de Epidemiologia, Prevención y Control de Enfermedades. Vigilancia, Prevención y Control de las Infecciones Intrahospitalarias [Internet]. [acceso: 05/03/2019]. Disponible en: Disponible en: https://www.dge.gob.pe/portal/index.php?option=com_content&view=article&id=547:documentos-7&catid=20:institucional&Itemid=383

  7. Quispe PZ. Indicadores epidemiológicos de referencia de infecciones intrahospitalarias - infecciones asociadas a la atención de la salud. Boletín Epidemiológico del Perú-2016. 2017;26(1):367-9.

  8. Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet. 2011;377(9761):228-41.

  9. World Health Organization. The burden of health care-associated infection worldwide: a summary. World Health Organization. 2010. [acceso: 05/03/2019]. Disponible en: Disponible en: https://www.who.int/gpsc/country_work/summary_20100430_en.pdf

  10. Ministerio de Salud. (2014). Protocolo de estudio de Infecciones Intrahospitalarias. MInisterio de Salud - Perú. [acceso: 05/03/2019]. Disponible en: Disponible en: http://www.dge.gob.pe/portal/docs/tools/iih/protocolos/23.pdf

  11. Consellería de Sanidade - Servizo Galego de Saúde. EPIDAT [Internet]. [acceso: 04/03/2019]. Disponible en: Disponible en: https://www.sergas.es/Saude-publica/EPIDAT?idioma=es

  12. Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate Point-Prevalence Survey of Health Care-Associated Infections. New England Journal of Medicine. 2014;370(13):1198-208.

  13. Leeds Institute for Data Analytics and Deutsche Forschungsgemeinschaft. DAGitty - drawing and analyzing causal diagrams (DAGs) [Internet]. [acceso: 04/03/2019]. Disponible en: Disponible en: http://www.dagitty.net

  14. Ministerio de Salud. Lineamientos para la vigilancia, prevencion y control de las Infecciones Asociadas a la Atencion de Salud. Ministerio de Salud - Perú. 2016. [acceso: 05/03/2019]. Disponible en: Disponible en: http://bvs.minsa.gob.pe/local/MINSA/3802.pdf

  15. Celis R, Torres A, Gatell JM, Almela M, Rodríguez-Roisin R, Agustí-Vidal A. Nosocomial pneumonia. A multivariate analysis of risk and prognosis. Chest. Feb 1988;93(2):318-24.

  16. Guzmán-Herrador B, Molina CD, Allam MF, Navajas RF-C. Independent risk factors associated with hospital-acquired pneumonia in an adult ICU: 4-year prospective cohort study in a university reference hospital. J Public Health (Oxf). 2016;38(2):378-83.

  17. De Souza PR, De Andrade D, Cabral DB, Watanabe E. Endotracheal tube biofilm and ventilator-associated pneumonia with mechanical ventilation. Microsc Res Tech. 2014;77(4):305-12.

  18. Bahrani-Mougeot FK, Paster BJ, Coleman S, Barbuto S, Brennan MT, Noll J, et al. Molecular Analysis of Oral and Respiratory Bacterial Species Associated with Ventilator-Associated Pneumonia. J Clin Microbiol. 2007;45(5):1588-93.

  19. Bochicchio GV, Napolitano L, Joshi M, Bochicchio K, Shih D, Meyer W, et al. Blood product transfusion and ventilator-associated pneumonia in trauma patients. Surg Infect (Larchmt). 2008;9(4):415-22.

  20. Likosky DS, Paone G, Zhang M, Rogers MAM, Harrington SD, Theurer PF, et al. Red Blood Cell Transfusions Impact Pneumonia Rates After Coronary Artery Bypass Grafting Surgery. Ann Thorac Surg. 2015;100(3):794-801.

  21. Ottonello L, Ghio M, Contini P, Bertolotto M, Bianchi G, Montecucco F, et al. Nonleukoreduced red blood cell transfusion induces a sustained inhibition of neutrophil chemotaxis by stimulating in vivo production of transforming growth factor-beta1 by neutrophils: role of the immunoglobulinlike transcript 1, sFasL, and sHLA- I . Transfusion. 2007;47(8):1395-404.

  22. American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171(4):388-416.

  23. Instituto de Evaluación de Tecnologías de Salud e Investigación IETSI. Guías de Práctica Clínica [Internet]. [acceso: 28/02/2019]. Disponible en: Disponible en: http://www.essalud.gob.pe/ietsi/guias_pract_clini.html




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