Use of a ventilator-associated pneumonia (VAP) bundle to decrease the VAP rate in Syria

Alsadat, Reem; Mazloum, Manal; Alshamaa, A; Dakkak, Abdulrahman; Al-bardan, Hussam; Eltayeb, Mudathir MohammedAhmed; Marie, A; Esber, Faten; Naes, Ola; Shama, Mohamed A.; Betelmal, Ibrahim; Kherallah, Mazen

doi:10.1186/cc10681

Cited by 2 publications

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“…According to the International Nosocomial Infection Control Consortium (INICC), the overall rate of VAP is 13.6 per 1,000 ventilator days. 2 The incidence varies according to the patient group and hospital setting. The incidence of VAP ranges from 13-51 per 1,000 ventilation days.…”

Section: Introductionmentioning

confidence: 99%

Ventilator-associated pneumonia

Charles¹,

Kali²,

Easow³

et al. 2014

AMJ

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BackgroundVentilator-associated pneumonia (VAP) is a type of nosocomial pneumonia that occurs in patients who receive mechanical ventilation (MV). According to the International Nosocomial Infection Control Consortium (INICC), the overall rate of VAP is 13.6 per 1,000 ventilator days. The incidence varies according to the patient group and hospital setting. The incidence of VAP ranges from 13-51 per 1,000 ventilation days. Early diagnosis of VAP with appropriate antibiotic therapy can reduce the emergence of resistant organisms. MethodThe aim of this review was to provide an overview of the incidence, risk factors, aetiology, pathogenesis, treatment, and prevention of VAP. A literature search for VAP was done through the PUBMED/MEDLINE database. This review outlines VAP's risk factors, diagnostic methods, associated organisms, and treatment modalities. ConclusionVAP is a common nosocomial infection associated with ventilated patients. The mortality associated with VAP is high. The organisms associated with VAP and their resistance pattern varies depending on the patient group and hospital setting. The diagnostic methods available for VAP are not universal; however, a proper infection control policy with appropriate antibiotic usage can reduce the mortality rate among ventilated patients. Key WordsVentilator-associated pneumonia, mechanical ventilation, clinical pulmonary infection score What this review adds: What is known about this topic?VAP is a type of nosocomial pneumonia, which increases mortality rates among critically ill patients. What new information is offered in this review?This review gives an overview of the incidence, pathogenesis, risk factors, aetiology, treatment, and prevention of VAP. What are the implications for research, policy, or practice?Greater awareness of VAP's risk factors, incidence, pathogenesis, and treatment can facilitate the creation of appropriate infection control measures to curb VAP among critically ill patients. BackgroundVentilator-associated pneumonia (VAP) is a type of nosocomial pneumonia that occurs in patients who receive mechanical ventilation.1 VAP is usually acquired in the hospital setting approximately 48-72 hours after mechanical ventilation. The main aim of mechanical ventilation is to aid in gas exchange without causing trauma to the lungs. Unfortunately, MV can harm the lungs by the stress and strain developed in the lung. High pressure and volume can cause barotrauma and volutrauma to the lungs, which is followed by biotrauma and atelectrauma. According to the International Nosocomial Infection Control Consortium (INICC), the overall rate of VAP is 13.6 per 1,000 ventilator days. 2 The incidence varies according to the patient group and hospital setting. The incidence of VAP ranges from 13-51 per 1,000 ventilation days. 3 The mean duration of

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Section: Introductionmentioning

confidence: 99%

Ventilator-associated pneumonia

Charles¹,

Kali²,

Easow³

et al. 2014

AMJ

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“…Ventilatör ilişkili pnömoni (VİP) genellikle mekanik ventilasyonun 48-72 saatinde gelişen bir nozokomial pnömoni tipidir (9). Uluslararası Enfeksiyon Kontrol Komitesinin verilerine göre dünya genelinde VİP oranı 1000 ventilatör günü için 13,6 olarak bildirilmiştir (10). Çeşitli merkezlerin verilerinde insidans 1000 ventilatör günü için 1-51 arasında değişmektedir (11), ortalama VİP süresi 5-7 gün, mortalite oranları %24-76 arasında olup kritik hastalarda oranın yüksel-diği gösterilmiştir (12).…”

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Clinical Case Solution: Prolonged Ventilatory Support and Weaning after Coronary Artery Bypass Graft Surgery

Yıldızeli¹,

Eryüksel²,

Arıkan³

et al. 2016

Yoğun Bakim Derg

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Coronary artery bypass graft (CABG) surgery is a common surgical procedure and has low complication rates. Extubation failure and prolonged ventilatory support are the most common complications in the first 24 h. These complications can be related to bleeding, respiratory problems, neurological complications, and cardiovascular problems. We hereby present a clinical case solution of prolonged weaning in an elderly patient who underwent CABG surgery and had to stay in the hospital for 2 months until he successfully recovered. A 65-year-old man developed cardiac arrest on the second postoperative day of the CABG surgery. The patient was transported to the medical intensive care unit (MICU) due to prolonged ventilatory support and weaning failure, 25 days after the operation. On admission, synchronized intermittent mandatory ventilation (SIMV) was started, and he was treated with vancomycin and ciprofloxacin for bacterial growth in blood cultures. He was evaluated for pulmonary edema, and diuretic therapy was started to attain a negative fluid balance. During the follow-up in the MICU, endotracheal aspirate cultures revealed Acinetobacter baumannii and Proteus mirabilis in his respiratory secretions, and the antibiotic treatment was changed. Tracheostomy was performed, and T-tube trials were started at the end of the second week in the MICU. After the first two T-tube trial failures, an investigation to determine the probable underlying reasons was started. A low phosphorus level was detected in the second week of the MICU follow-up, and replacement was made. A respiratory physiotherapy program was initiated on the 30 th day. On the 58 th day in the MICU, the patient was transferred to the patient ward; at the end of the second month, the tracheostomy was decannulated, and he was discharged from the hospital. Prolonged ventilatory support and weaning is a common problem in MICU and surgical intensive care unit patients and is associated with increased mortality and complications. These patients must be evaluated for respiratory, cardiac, neuromuscular, psychiatric, and metabolic problems. A close follow-up of the nutritional status and muscle strength are also advised by the authors. Koroner arter bypass greft (KABG) cerrahisi tüm dünyada yaygın olarak yapılan ve beklenen komplikasyon oranı düşük bir cerrahidir. Ekstübasyon başarısızlığı ve uzamış ventilator desteği ilk 24 saatte en sık görülen komplikasyonlardır. Bu komplikasyonlar; kanama, respiratuvar problemler, nörolojik komplikasyonlar ve kardiyovasküler problemler ile ilişkili olabilmektedir. Bu klinik vaka çözümleme olgusunda KABG cerrahisi sonrasında uzamış ventilator desteği ve weaning nedeniyle 2 ay hastane yatış ihtiyacı olan olgudan bahsedilmektedir. Altmış beş yaşında erkek hasta KABG cerrahisinin ikinci gününde kardiyak arrest nedeniyle re-entübe edilmişti. Post operatif 25. günde uzamış mekanik ventilator desteği ve weaning başarısızlığı nedeni ile dahili yoğun bakım ünitesine (DYBÜ) kabul edildi. Gelişinde eşzamanlı aralıklı zorunlu ventilasyon (SI...

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Use of a ventilator-associated pneumonia (VAP) bundle to decrease the VAP rate in Syria

Cited by 2 publications

References 0 publications

Ventilator-associated pneumonia

Ventilator-associated pneumonia

Clinical Case Solution: Prolonged Ventilatory Support and Weaning after Coronary Artery Bypass Graft Surgery

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