Icu Tracheostomy Patients With Lower Respiratory Tract Infections Related Factors Analysis

Objective: To study the risk factors of patients with lower respiratory infection after ventilator-assisted breathing in intensive care unit (ICU), and reveal the flora distribution in respiratory tract's variation due to risk factors after tracheotomy , to provide a basis for prevention and control of the lower respiratory infection after tracheotomy.Methods: 20 patients were accepted, we gathered samples on skin of neck before tracheotomy, and gathered 12 samples on buccal cavity, professional jargon, pharyngeal secretion, sputum at lower respiratory tract, ward atmosphere, article surface, drainage tube, pipeline interface of breathing machine, humidification bottle, tracheotomy cannula and hands of nurse respectively at the first day, fifth day, tenth day, fifteenth day after tracheotomy, and then analyze the characteristics of patients' respiratory tract flora distribution after ventilator-assisted breathing, and the related factors effect to lower respiratory infection.Results: The lower respiratory infection incidence is 95% after tracheotomy, ? especially within one week. Following temporal extension, flora species at the respiratory tract appeared a change from common to drug resistance, and pathogenic bacterium are mainly gram-negative bacillus and gram-positive coccus. Using comprehensive evaluation method—AHP (Analytic Hierarchy Process) to analysis lower respiratory infection pathogens' variation in ICU ward and General index (GI) is used to illuminate the relationship. The GI of ICU wards pathogenic bacteria respectively show as: 2680 (humidification bottle), 2209(pipeline interface of breathing machine), 2097(drainage tube), 849.3(tracheal incision site), 430.55(buccal cavity), 379.61(tracheotomy cannula),263.45(ward atmosphere), 116.4(article surface), 67.05(hands of nurses).The results shows that the mainly variation of ICU wards pathogenic bacteria focus on medical-related equipment , while the variation of the tracheal incision site in patients and oral bacteria of the patients has been a marked decline in effectiveness. Environmental factors and care factors, compared with the former, its pathogenic role in the comprehensive effect of the variation have been relatively weaken the overall impact of small changes in bacteria. Conclusion: (1) After tracheotomy, patients with ventilator-assisted breathing have a high incidence of lower respiratory infection in intensive care unit (ICU), especially within one week. (2) Pathogenic bacterium after tracheotomy are mainly gram-negative bacillus; the strains with stronger virulence and drug resistance become more and more following temporal extension. (3) After tracheotomy respiratory tract flora distribution has a relation with kinds of factors, mainly related to the equipment pipeline, but has no obvious relevance with hands of nurse, atmosphere and article surface. (4) Analytic Hierarchy Process, easy to employ and master, showed variation of pathogenic bacteria regularity comprehensively. It is convenient to make further analysis and comparisons. However, the result is of a little subjectivity since people were involved in the process of determining appraisal index and weight. In popularizing the method, how to avoid subjectivity and improve the exactness and properness of comprehensive evaluation should be further discussed.