Publication: Incidence and Risk Factors for Ventilator-Associated Pneumonia in Kathmandu University Hospital
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Date
2011
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Ventilator associated pneumonia is a major cause of morbidity in the intensive care
unit. Difficulties in identification of the risk factors, in diagnosing and in prevention,
have intensified the problem.
Objectives
To measure the incidence of ventilator associated pneumonia in intensive care unit
and to identify the risk factors associated.
Methods
A prospective observational cohort study of 69 patients who were mechanically
ventilated for more than 48 hours were evaluated to find out the development
of nosocomial pneumonia and presence or absence of risk factors. Data were
subjected to univariate analysis using chi-square and t-test. Level of significance
was set at 0.05.
Results
Twenty two (31.88%) out of 69 patients developed ventilator associated
pneumonia, majority of them between four days to 14 days. Reintubation, invasive
lines, H2 blockers and low PaO2/FiO2 were identified as major risk factors in our
study. Enteral feeding via nasogastric tube and use of steroids was not associated
with development of ventilator associated pneumonia. The patients with ventilator
associated pneumonia had significantly longer duration of mechanical ventilation
(18.88±7.7 days vs 7.36±4.19 days) and stay (29±17.8 days vs 9.22±5.14 days).
The morality was similar for both the groups with or without ventilator associated
pneumonia.
Conclusion
The incidence of ventilator pneumonia is high. Patients requiring prolonged
ventilation, re-intubation, more invasive lines and H2 blockers, are at high risk and
need special attention towards prevention.
KEY WORDS
nosocomial infection, prolonged mechanical ventilation, risk factors, ventilator
associated pneumonia
Description
Ranjit S, Bhattarai B
Department of Anaesthesiology Dhulikhel Hospital - Kathmandu University Hospital, Kavre, Nepal