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2023, Number 3

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Med Crit 2023; 37 (3)

Usefulness of the modified Neumonia Zero protocol to reduce the incidence of pneumonia associated with mechanical ventilation in the ICU of the ISSSTE Morelia Regional Hospital

Medina LJL, Camacho CMN

Language: Spanish
References: 24
Page: 219-223
PDF size: 199.91 Kb.


ABSTRACT

Ventilator-associated pneumonia is currently considered a global emergency because the causative microorganisms have generated antimicrobial resistance. In a retrospective study that was carried out in our intensive care unit, 206 annual admissions were found, of which they correspond from January 15, 2021 to December 15, 2021; 83 positive cultures of bronchial secretion were found, corresponding to 40.2% of all admissions, with an annual incidence rate of 41%. Of the total study, 35 cultures correspond to Acinetobacter baumannii (16.9%), Stenotrophomonas maltophilia; seven positive cultures (4.35%), Staphylococcus aureus eight corresponding to (3.87%), Pseudomonas sp. seven positive cultures (3.39%), E. coli seven positive cultures (3.39%), Staphylococcus epidermidis six cultures (2.90%), Klebsiella pneumoniae four cultures (1.93%), Enterococcus faecalis two cultures (0.06%), S. marcescens and Streptococcus pneumoniae with one culture respectively (0.48%); for all this it is necessary to carry out measures that reduce said incidence, the magnification of this project by estimating the high daily costs of the intensive care unit can reduce the costs to the institution. The objective of this study is to generate preventive measures to reduce the incidence of pneumonia associated with mechanical ventilation in the ICU of the Morelia ISSSTE Regional Hospital. The study consists of implementing the modified Neumonia Zero protocol that consists of seven preventive actions which are: 1) Head position between 20 and 35o. 2) Avoid routine change of fan circuit. 3) Perform cleaning with chlorhexidine prior to aspiration of secretions. 4) Clean hands with alcohol solutions prior to aspiration of secretions. 5) Verify pressure of the pneumotamponade balloon (20-25 mmHg) prior to aspiration of secretions. 6) Carry out daily actions that reduce sedation. 7) Place a 14 Fr orogastric tube. A checklist was made and the seven actions per shift were reviewed, filling in per shift, during the implementation period of the study.


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