medigraphic.com
ISSN 1810-2352 (Print)

2015, Number 1

<< Back

Rev Cub Med Int Emerg 2015; 14 (1)

Study of factors of risk of the pneumonia associated with the ventilation

Soneira PJ, Soneira MJM, Rivero LFM, Díaz LY, Arteaga CY

Language: Spanish
References: 34
Page: 87-96
PDF size: 156.14 Kb.


ABSTRACT

Introduction: The detection of the factors of risk for the pneumonia associated with the ventilation, as well as their precocious diagnosis allows to improve the presage of the subjected patients to mechanical ventilation.
Objective: Identifying the main factors of risk for the development of nosocomial pneumonia associated with the mechanical ventilation.
Method: observational, longitudinal and retrospective study of 122 subjected patients to mechanical ventilation in the understood period between January of 2010 to December of 2011 in the intensive care units of the Hospital Miguel Enríquez.
Results: The factors of identified risk for the appearance of pneumonia associated with the ventilation included the realization of traqueotomy, the use of systemic steroids and the habit of smoking. The factors of risk associated with the identified mortality was the use of previous antibiotics and the polytraumatisms. Among the isolated germs prevailed the negative gram and polymicrobian infections. They prevailed the resistant germs to more than 5 antibiotics.
Conclusions: It was demonstrated a statistically significant relationship between the state of the discharged patients and the previous use of antimicrobians, the antecedent of trauma as well as the duration of the mechanical ventilation. Multiresistent germs were isolated.


REFERENCES

  1. Abdel-Fattah MM. Nosocomial pneumonia: Risk factors, rates and trends. East Mediterr Health J. 2008;14(3):546-555.

  2. Blanquer J, Aspa J, Anzueto A . SEPAR Guidelines for Nosocomial Pneumonia. Arch Bronconeumol. 2011;47(10):510-520.

  3. Esperatti M, Ferrer M, Theessen A. Nosocomial pneumonia in the intensive care unit acquired by mechanically ventilated versus nonventilated patients. Am J Respir Crit Care Med. 2010;182(12):1533-1539.

  4. Lin SM, Wang TY, Liu WT . Predictive factors for mortality among non-HIV-infected patients with pulmonary tuberculosis and respiratory failure. Int J Tuberc Lung Dis. 2009;13(3):335-340.

  5. Krysanova IS, Kulikov AI. Pharmacoeconomic evaluation of nosocomial pneumonia treatment. Antibiot Khimioter. 2008;53(1-2):33-38.

  6. Worrall CL, Anger BP, Simpson KN, Leon SM. Impact of a hospitalacquired/ ventilator-associated/healthcare-associated pneumonia practice guideline on outcomes in surgical trauma patients. J Trauma. 2010;68(2):382-386.

  7. Beyersmann J, Kneib T, Schumacher M, Gastmeier P. Nosocomial infection, length of stay, and time-dependent bias. Infect Control Hosp Epidemiol. 2009;30(3):273- 276.

  8. Barnett A, Graves N. Competing risks models and time-dependent covariates. Crit Care. 2008;12(2):134.

  9. Gajovic O, Todorovic Z, Mijalilovic Z. Incidence, risk factors and outcome of nosocomial pneumonia patients with central nervous system infections. Srp Arh Celok Lek. 2011;139(7-8):476-480. 94 Rev Cub Med Int Emerg 2015;14(1) Factores de riesgo de la neumonía asociada a la ventilación

  10. Shi S, Zhao Z, Liu X. Perioperative risk factors for prolonged mechanical ventilation following cardiac surgery in neonates and young infants. Chest. 2008;134(4):768- 774.

  11. Wolkewitz M, Vonberg RP, Grundmann H. Risk factors for the development of nosocomial pneumonia and mortality on intensive care units: application of competing risks models. Crit Care. 2008;12(2):R44.

  12. Akinnusi ME, Hattemer A, Gao W, El-Solh AA. Does linezolid modulate lung innate immunity in a murine model of methicillin-resistant Staphylococcus aureus pneumonia? Crit Care Med. 2011;39(8):1944-1952.

  13. Bassetti M, Repetto E, Righi E. Colistin and rifampicin in the treatment of multidrugresistant Acinetobacter baumannii infections. J Antimicrob Chemother. 2008;61(2):417-420.

  14. Falagas ME, Siempos II, Rafailidis PI, Korbila IP, Ioannidou E, Michalopoulos A. Inhaled colistin as monotherapy for multidrug-resistant gram (-) nosocomial pneumonia: a case series. Respir Med. 2009;103(5):707-713.

  15. Poch DS, Ost DE. What are the important risk factors for healthcare-associated pneumonia? Semin Respir Crit Care Med. 2009;30(1):26-35.

  16. Bordon A, Bokhari R, Sperry J, Testa D, Feinstein A, Ghaemmaghami V. Swallowing dysfunction after prolonged intubation: analysis of risk factors in trauma patients. Am J Surg. 2011;202(6):679-682.

  17. Beaulieu M, Williamson D, Sirois C, Lachaine J. Do proton-pump inhibitors increase the risk for nosocomial pneumonia in a medical intensive care unit? J Crit Care. 2008;23(4):513-518.

  18. Barba R, Martinez JM, Zapatero A . Mortality and complications in very old patients (90+) admitted to departments of internal medicine in Spain. Eur J Intern Med. 2011;22(1):49-52.

  19. Luksamijarulkul P, Wisutthipate S, Kaewpan W, Saisung S. Incidence and risk factors for nosocomial pneumonia among intubated patients in a provincial hospital, Eastern Thailand. Southeast Asian J Trop Med Public Health. 2008;39(1):168-175.

  20. Friese RS, Sperry JL, Phelan HA, Gentilello LM. The use of leukoreduced red blood cell products is associated with fewer infectious complications in trauma patients. Am J Surg. 2008;196(1):56-61.

  21. Curcio D, Ali A, Duarte A . Prescription of antibiotics in intensive care units in Latin America: an observational study. J Chemother. 2009;21(5):527-534.

  22. Avazashvili N, Nozadze T, Chikviladze D, Gachechiladze K, Metreveli D, Mikeladze M et al. Microbial spectrum of nosocomial pneumonia in traumatological patients. Georgian Med News. 2011;(194):76-79.

  23. Giamarellou H, Poulakou G. Multidrug-resistant Gram-negative infections: What are the treatment options? Drugs. 2009;69(14):1879-1901.

  24. Haque NZ, Arshad S, Peyrani P. Analysis of pathogen and host factors related to clinical outcomes in patients with hospital-acquired pneumonia due to methicillinresistant Staphylococcus aureus. J Clin Microbiol. 2012,96:512-516

  25. Maviglia R, Nestorini R, Pennisi M. Role of old antibiotics in multidrug resistant bacterial infections. Curr Drug Targets. 2009;10(9):895-905.

  26. Ott E, Bange FC, Reichardt C. Costs of nosocomial pneumonia caused by meticillin-resistant Staphylococcus aureus. J Hosp Infect. 2010;76(4):300-303. 95 Rev Cub Med Int Emerg 2015;14(1) Factores de riesgo de la neumonía asociada a la ventilación

  27. Chen WH, Kang TJ, Bhattacharjee AK, Cross AS. Intranasal administration of a detoxified endotoxin vaccine protects mice against heterologous Gram-negative bacterial pneumonia. Innate Immun. 2008;14(5):269-278.

  28. Jean SS, Hsueh PR. Current review of antimicrobial treatment of nosocomial pneumonia caused by multidrug-resistant pathogens. Expert Opin Pharmacother. 2011;12:2145-2148.

  29. Bassetti M. Strategies for management of difficult to treat Gram-negative infections: focus on Pseudomonas aeruginosa. Infez Med. 2007;15(Suppl 2):20-26.

  30. De CE, Krueger WA, Sorensen S . Cost-effectiveness of linezolid vs vancomycin in suspected methicillin-resistant Staphylococcus aureus nosocomial pneumonia in Germany. Infection. 2009;37(2):123-132.

  31. Frickmann H, Crusius S, Walter U, Podbielski A. Management of an Outbreak with Cases of Nosocomial Pneumonia Caused by a Novel Multi-Drug-Resistant Acinetobacter baumannii Clone. Pneumologie. 2010;64(11):686-693.

  32. Pinheiro B, V, Tostes RO, Brum CI, Carvalho EV, Pinto SP, Oliveira JC.et al. Early versus late tracheostomy in patients with acute severe brain injury. J Bras Pneumol. 2010;36(1):84-91.

  33. Poulard F, Dimet J, Martin-Lefevre L. Impact of not measuring residual gastric volume in mechanically ventilated patients receiving early enteral feeding: a prospective before-after study. JPEN J Parenter Enteral Nutr. 2010;34(2):125-130.

  34. Hingston CD, Cole JM, Hingston EJ, Frost PJ, Wise MP. Oral hygiene and nosocomial pneumonia in critically ill patients. Chest. 2010;137(1):237-238.




2020     |     www.medigraphic.com