Ventilator associated pneumonia

Hunter, J. D.

doi:10.1136/pgmj.2005.036905

Cited by 87 publications

(51 citation statements)

References 85 publications

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“…By contrast, pneumonia was detected in only 6.7% of the present RCW patients but occurred at a significantly higher rate in the ICUs of this and other studies [3,6,28]. The reduced incidence of pneumonia from ICUs to the RCC and RCW in this hospital was assumed to correlate with resolving acute illness, strategies that limit aspiration [29,30], aggressive chest care and the use of better weaning protocols in the RCW and the RCC.…”

Section: Discussioncontrasting

confidence: 60%

Antimicrobial resistance of bacterial isolates from respiratory care wards in Taiwan: a horizontal surveillance study comparison of the characteristics of nosocomial infection and antimicrobial-resistant bacteria in adult Intensive Care Units and two respiratory care facilities for mechanically ventilated patients at a tertiary care centre in Taiwan

Liu¹,

Lai

et al. 2011

International Journal of Antimicrobial Agents

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Section: Discussioncontrasting

confidence: 60%

Antimicrobial resistance of bacterial isolates from respiratory care wards in Taiwan: a horizontal surveillance study comparison of the characteristics of nosocomial infection and antimicrobial-resistant bacteria in adult Intensive Care Units and two respiratory care facilities for mechanically ventilated patients at a tertiary care centre in Taiwan

Liu¹,

Lai

et al. 2011

International Journal of Antimicrobial Agents

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“…Increased respiratory morbidity in patients receiving general anesthesia may be positively correlated with endotracheal intubation and its association with respiratory infections, such as pneumonia, in the long run [19–21]. This has also been proven in a large scale, multicenter study conducted in 126 hospitals in New York.…”

Section: Discussionmentioning

confidence: 98%

Hip Fracture Surgery: Does Type of Anesthesia Matter?

Rashid

Shah

Shakoor

et al. 2013

BioMed Research International

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Background. Hip fracture surgery is a common procedure, and the geriatric population with its multiple comorbid conditions is at most at risk of developing anesthesia-related complications. Data on the impact of type anesthesia on postoperative morbidity and mortality is limited. The effects of regional and general anesthesia on postoperative outcomes need to be clearly elucidated. Methods. In this study, all patients who underwent dynamic hip screw (DHS) fixation for intertrochanteric fractures, between January 2005 and December 2010, at the Aga Khan University Hospital, were included. Patients were divided into two groups; group A included those patients who received general anesthesia, and group B consisted of patients who had received regional anesthesia. The two groups were compared for differences in morbidity, mortality, and intraoperative complications based on the type of anesthesia administered. Results. During this period, 194 patients underwent DHS fixation. One hundred and seven patients received general anesthesia whereas eighty-seven patients received regional anesthesia. The mean operative time was significantly lower in the group receiving regional anesthesia (1.25 ± 0.39 hrs) as compared to those who received general anesthesia (1.54 ± 0.6 hrs) (P < 0.05). There were no statistically significant differences in the rates of wound infections, length of hospital stay, postoperative ambulation status, intraoperative blood loss, postoperative complications, and mortality between the regional and general anesthesia groups. Conclusion. Even though administration of regional anesthesia was positively correlated with shorter operative duration, the type of anesthesia was not found to affect surgical outcomes in the two study groups. Based on these results, we recommend that anesthesia should be tailored to individual patient requirements.

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“…Sedatif ve paralitik ajanların bilinç durumunda değişikliklere yol açıp, öksürük refl eksini baskılayarak aspirasyon riskini artırdıkları düşünülmektedir. Ayrıca sedatif infüzyonunun aralıklı verilmesinin MV süresini kısalttığı vurgulanmaktadır (29,30). Çalışmamızda, sedatif ajan kullanılanlarda daha yüksek oranda VİP gözlenmiştir, ancak istatistiksel olarak anlamlı fark bulunmamıştır.…”

Section: Tablo 4 Ventilatörle İlişkili Pnömoni Risk Faktörleri çOk Dunclassified

Risk Factors for Ventilator-Associated Pneumonia Developing in Patients Admitted to Intensive Care Unit

Uslu¹,

Öztürk²,

Kuşçu³

et al. 2010

Klimik Dergisi

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ÖzetAmaç: Bu çalışmada medikal yoğun bakım ünitelerinde ventilatörle ilişkili pnömoni (VİP) gelişmesine etki eden risk faktörlerinin saptanması amaçlanmıştır. Yöntemler: 16 yaş ve üzeri, 48 saatten fazla mekanik ventilatöre bağlı kalan, ilk yatışta akciğer infeksiyonu olmayan hastalar çalışmaya alındı. İstatistiksel analizler için STATA 9.0 ® (College Station, TX, USA) bilgisayar programı kullanıldı. Sonuçlardan p değeri <0.05 olanlar anlamlı kabul edildi. Bulgular: 142 hasta çalışmaya alındı. Hastaların 64 (%45.1)'ünde VİP gelişti. 1000 ventilasyon günü için VİP hızı 23.3 idi. Çalışmada intübasyon ve mekanik ventilasyon süresinin uzaması (p<0.001), hastanede (p<0.001) ve yoğun bakımda yatışın uzaması (p<0.001), APACHE II skorunun yüksekliği (p<0.001), kan transfüzyonu (p<0.001), enteral beslenme (p=0.025), üriner infeksiyon (p<0.001), yara infeksiyonu (p=0.045), en az bir bölgede infeksiyon varlığı (p<0.001), kronik obstrüktif akciğer hastalığı (KOAH) (p=0.003), diabetes mellitus (DM) (p<0.001), önceki antibiyotik kullanımı (p=0.003), trakeostomi açılması (p=0.003) ve santral kateter varlığı (p<0.001) VİP gelişmesi için risk faktörü olarak saptandı. Lojistik regresyon analizinde intübasyon süresinin uzaması (p=0.015), APACHE II skorunun yüksekliği (p=0.001), kan transfüzyonu (p=0.015), KOAH (p=0.036), DM (p=0.019) ve santral kateter varlığı (p<0.001) bağımsız risk faktörleri olarak tespit edildi. Sonuçlar: VİP için tanımlanmış risk faktörlerinin bilinip, VİP'in önlenmesi için etkin infeksiyon kontrol programlarının uygulanması, her ünitede sürveyans sonuçlarının düzenli olarak değerlendirilmesi ve uygun tedbirlerin alınması gerekir. Klimik Dergisi 2010; 23(3): 83-8.Anahtar Sözcükler: Ventilatörle ilişkili pnömoni, yoğun bakım ünitesi, risk faktörleri. AbstractObjective: The aim of this study was to investigate risk factors for ventilator-associated pneumonia (VAP) which developed in patients admitted to medical intensive care units. Methods: Patients who were 16 years old and above, dependent on a mechanical ventilator for more than 48 hours and without pulmonary infection on fi rst admission were included in the study. STATA 9.0 ® (College Station, TX, USA) was employed for statistical analyses and p<0.05 was regarded as the signifi cant value. Results: This study included 142 patients and 64 (45.1%) developed VAP. The incidence of VAP was 23.3 cases per 1000 ventilator-days. Univariate analysis showed that duration of mechanical ventilation (p<0.001), length of intensive care unit (p<0.001) and hospital stay (p<0.001), the APACHE II score (p<0.001), blood transfusion (p<0.001), enteral feeding (p=0.025), urinary infection (p<0.001), wound infection (p=0.045), presence of at least one region of infection (p<0.001), chronic obstructive pulmonary disease (p=0.003), diabetes mellitus (p<0.001), prior antibiotics (p=0.003), tracheotomy (p=0.003) and presence of central catheter (p<0.001) were associated with the development of VAP. Logistic regression analysis showed a relationship between VAP and duration of mecha...

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Ventilator associated pneumonia

Cited by 87 publications

References 85 publications

Hip Fracture Surgery: Does Type of Anesthesia Matter?

Risk Factors for Ventilator-Associated Pneumonia Developing in Patients Admitted to Intensive Care Unit

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