Clinical Analysis Of Ventilation Patients Combined In68Patients With Ventilator-associated Pneumonia In Neurology Incentive Care Unit

Object:To analyze, discuss and explore the risk factors, clinical symptoms and treatment effectsof ventilation combined ventilator-associated pneumonia (VAP) disease, by analyzing theclinical data of patients with such disease hospitalized in neurology incentive care unit(NICU).Methods:68cases were collected from Jan1,2013to July1,2013in NICU of our hospital. Basedon whether or not combining VAP, we divided them into VAP and non-VAP group,respectively. Retrospective method was used. The clinical data included general demographyindex (age and sex), baselines possibly related to VAP (case history and related clinicallaboratory results on admission, other previous history including stroke, lung disease,long-term bed, diabetes, high blood pressure (HBP) and coronary heart disease (CHD)). Then,we classified these data mainly by major primary disease, complications, antibioticsadministration, days for hospitalization, medical care costs and turnover situation,respectively. Statistics software SPSS17.0was applied for analyzing these data. Numerationdata were checked by X2test and measurement data were determined by t test or rank test,respectively. P<0.05was used as the significant level. According to the statistics reports, wefurther selected the possible related factors to ventilation combined VAP disease. The detailsfor the statistics process were followed: other complications rates were compared with X2testbetween two groups; turnover situation, days for hospitalization and medical care costs werecompared with rank test. The final results were shown with median, minimum and maximum.Results:1. Among the total68cases with ventilation, there were58cases combined with VAP, whosepercentage was85.3%. The numbers for early onset pneumonia (EOP) and late onsetpneumonia (LOP) patients were24(41.4%) and34(58.6%), respectively.2. The following may be the risk factors of ventilation combined VAP disease, such aslong-term bed, HBP and hyper-fasting blood sugar. 3. Compared with patients in non-VAP group(20%), abnormal liver function wassignificantly higher in VAP group(79.3%)(P<0.001). In non-VAP group(0%) death ratewas significantly higher in VAP group(17.2%).4. Compared with the non-VAP group, total medical care costs (VAP group124500yuan,nVAP62670yuan) days for hospitalization in NICU (VAP group23, nVAP group15).Duration of mechanical ventilation (VAP group15, nVAP7). Was significantly higher.5. In VAP group, patients all had done the sputum culture check and the percentage ofsputum culture was100%. Among them, there were43cases with positive symptom(74.1%). The details were that,41cases (95.35%). with gram negative infection,14cases(32.6%) with gram positive infection and11cases (25.6%) with fungal infection. thesequence of Pseudomonas aeruginosa.the acinetobacter baumannii.the klebsiellapneumonia. sensitive Staphylococcus aureus is the most culture.6. The sensitivities of main pathogenic bacteria to common antibiotics were following: thesequence of Pseudomonas aeruginosa to sensitive antibiotics(higher to lower) wasciprofloxacin>levofloxacin>meropenem; for Acinetobacter baumannii, it wasmeropenem>imipenem>levofloxacin; for Escherichia coli, it was cefoperazone/sulbactam> cefepime>ceftazidime; for Klebsiella pneumonia; it was imipenem>meropenem>ceftazidine; for sensitive Staphylococcus aureus, it was linezolid>vancomycin>teicoplanin.Conclusion:(1) For ventilation cases, the incidence was higher to combine with VAP in NICU. Therewere the risk factors of ventilation combined VAP disease, including long-term bed, HBP,and hyper-fasting blood sugar et al.(2) For ventilation cases combined with VAP, they alsohad much higher opportunities with simultaneously happening other complications andadverse affairs.(3) The main pathogenic bacterium was gram negative bacterium forventilation combined VAP disease. The Acinetobacter baumannii was main.