Mechanical Ventilation In Patients With Ventilator-associated Pneumonia Risk Factors And Prognosis

Objective:Clinical analysis of patients with ventilator-associated pneumonia (VAP), VAP, risk factors, prognosis, and its characteristics.Methods:The selection of critical care medicine inpatient hospital in July2010to March2012the establishment of artificial gas points to156cases. Closely observe the patients’vital signs (body temperature, pulse, respiration, blood pressure and so on), arterial blood-gas changing and sputum properties, and suspected of being infected with the object to give sputum culture check. Queue study, patients with possible risk factors of ventilator-associated pneumonia and ventilator-associated pneumonia in patients with ventilation time and length of stay compared.Results:In this group of156patients with mechanical ventilation of patients,45patients got the ventilator associated pneumonia (VAP).The incidence rate was28.8%. In the group of45patients, since the establishment of artificial airway to getting the ventilator-associated pneumonia (VAP), the time was from the48h to30days, for an average of (10.5±2.4) days. The risk factors for the single factor analysis, COPD history)15years, albumin<30g/L, and continuous use of antibiotics>3days,13factors were statistically significant. Multivariate analysis showed that, while using the above two kinds of antibiotics, repeated tracheal intubation, APACHE II score>15points, gastric juice pH>4, mechanical ventilation time were independent risk factors for VAP. Analyzing the results of sputum culture, we could find31cases (68.9%) was a single pathogen infection,14cases (31.1%) was two or more than two kinds of pathogens, and3cases mixed with fungal infection. The major pathogen Pseudomonas aeruginosa, Acinetobacter bacteria level of E. coli resistance statistics:its resistance to traditional antimicrobial agents penicillin, ciprofloxacin, cephalosporins and other higher meropenem, imipenem, amikacin, and enzyme inhibitors, with high sensitivity. Comparing the time of mechanical ventilation (MV) of two groups of patients,2d<<MV<5d decreased significantly,-5d<<MV<7d and MV>>7d increased. In the length of hospital stay, the hospitalization time of ventilator-associated pneumonia patients was significantly prolonged.Conclusion:Ventilator-associated pneumonia (VAP) in the intensive care unit in a higher incidence of its occurrence is the combined effect of the results of many factors. More than two kinds of combination of antibiotics, APACHE Ⅱ score)15is divided into the two largest factors in the relative risk factors. VAP patients with poor prognosis, seriously affect the survival of the patient’s treatment. VAP treatment and prevention are urgently needed.