2005, Number 5-6
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Med Crit 2005; 19 (5-6)
Ventilator associated pneumonia: incidence, etiology and risk factors in a General Intensive Care Unit
Martínez GM, Lazo VS, Eraña GJA
Language: Spanish
References: 28
Page: 163-168
PDF size: 86.27 Kb.
ABSTRACT
Introduction: Pneumonia is a frequent complication of invasive mechanical ventilation (IMV) that increases mortality and hospital stay.
Objective: To study the incidence of pneumonia in patients with IMV.
Design: Retrospective study.
Setting: ICU of a private general hospital of San Luis Potosi City, Mexico.
Patients and methods: All patients admitted to the ICU from July 1st 2002 to June 30th 2004 who required IMV were studied. We collected demographic data, diagnosis, IMV length, use of drugs, details about intubation, and sputum culture results. During the study period, 66 patients required IMV for more than 48 hours; 10 patients who already had pneumonia at admission were excluded. The incidence of ventilator-associated pneumonia (VAP) was 33% (22 cases), that were compared with 34 controls. Risk factors with statistical significance were one or more reintubations, tracheostomy and IMV for more than 5 days.
REFERENCES
Consenso Mexicano de Diagnóstico y Tratamiento de la Neumonía. Neumonías: Un Consenso Nacional de Expertos. Dresde Editorial Médica, 2002.
Kollef MH. The prevention of ventilator-associated pneumonia. N Engl J Med 1999;340:627-634.
Jiménez P, Torres A, Rodríguez-Roisin R et al. Incidence and etiology of pneumonia acquired during mechanical ventilation. Crit Care Med 1989;17:882-885.
Rello J, Quintana E, Auxina V et al. Incidence, etiology, and outcome of nosocomial pneumonia in mechanically ventilated patients. Chest 1991;100:439-444.
Molinar F, Vázquez MI, Baltasar JA, Salazar D, Cruz E. Incidencia de neumonía asociada a la ventilación mecánica en pacientes críticos. Rev Asoc Med Crit y Ter Int 2001;XV:18-21.
Chastre J, Fagon JY. Ventilator-associated Pneumonia. Am J Respir Crit Care Med 2002;165:867-903.
CooK DB, Walter SD, Cook RJ et al. Incidence and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Int Med 1998;129:433-440.
MMWR Guidelines for Prevention of Nosocomial Pneumonia. 1997;46(RR-1):1-79.
Akca O, Koltka K, Uzel S et al. Risk factors for early-onset, ventilator associated pneumonia in critical care patients: selected multiresistant versus nonresistant bacteria. Anesthesiology 2000;93:638-645.
Trouillet JL, Vuagnat A, Combes A et al. Pseudomonas aeruginosa ventilator-associated pneumonia: comparison of episodes due to piperacillin-resistant vs piperacillin-susceptible organism. Clin Infect Dis 2002;34:1047-1054.
Solórzano F, Díaz R, Miranda MG. Tópicos selectos en neumonías nosocomiales. Ed Grapondi, 2003.
Mukhopadhyay C, Bhargava A, Ayyagari A. Role of mechanical ventilation and development of multidrug resistant organisms in hospital acquired pneumonia. Indian J Med Res 2003;118:229-35.
Richards M, Edwards J, Culver D et al. Nosocomial Infections in Medical Intensive Care Units in the United States. Crit Care Med 1999;27:887-892.
Kollef M. Ventilator-associated Pneumonia. A multivariate analysis. JAMA 1993;270:1965-70.
Gaynes R, Bizek B, Mowry-Hanlye J, Kirsh M. Risk factors for nosocomial pneumonia after coronary artery bypass graft operations. Ann Thorac Surg 1991;51:215-8.
Vincent JL, Bihari DJ, Suter PM et al. The Prevalence of Nosocomial Infection in Intensive Care Units in Europe (EPIC). JAMA 1995;274:639-644.
Torres A, Aznar R, Gatell JM et al. Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis 1990;142:523-528.
Ponce de León S, Molinar F, Domínguez G, Rangel S, Vázquez VG. Prevalence of Infections in Intensive Care Units in Mexico: A multicenter study. Crit Care Med 2000;28:1316-1321.
Holzapfel L, Chevret S, Madinier G et al. Influence of Long-term Oro- or nasotracheal intubation on nosocomial maxillary sinusitis and pneumonia: results of a prospective, randomized, clinical trial. Crit Care Med 1993;21:1132-1138.
Olson M, Harmon B, Kollef MH et al. Silver-coated endotracheal tubes associated with reduced bacterial burden in the lungs of mechanically ventilated dogs. Chest 2002;121:863-870.
Richards MJ, Edwards JR, Culver DH et al. Nosocomial Infections in Coronary Care Units in the United States. Am J Cardiol 1998;82:789-793.
Guerra LF, Baughman RP. Use of bronchoalveolar lavage to diagnose bacterial pneumonia in mechanically ventilated patients. Crit Care Med 1990; 18:169-173.
Wunderink RG, Mayhall G, Gibert C. Methodology for clinical investigation of ventilator-associated pneumonia. Chest 1992;102:580S-588S.
Cockerill FR, Muller SR, Anhalt JP et al. Prevention of infection in critically ill patients by selective decontamination of the digestive tract. Ann Int Med 1992;117:545-553.
Meduri GU. Ventilator-associated pneumonia in patients with respiratory failure. Chest 1990;97:1208-1219.
Fagon JY, Chastre J, Hance AJ, Domart Y, Touillet JL, Gibert C. Evaluation of clinical judgment in the identification and treatment of nosocomial pneumonia in ventilated patients. Chest 1993;103:547-553.
Craven DE, Kunches LM, Kilinsky V, Lichtenberg DA, Make BJ, Mccabe WR. Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation. Am Rev Respir Dis 1986;133:792-796.
Fagon J, Chastre J, Vuagnat A, Trouillet J-L, Novara A, Gibert C. Nosocomial pneumonia and mortality among patients in intensive care units. JAMA 1996;275:866-869.