The Correlation Research Of Ventilator Associated Pneumonia Incidence Rate And Sedation Therapy

BackgroundUse breathing machine is one of the important methods of ICU patients rescue treatment.A common complication is ventilator associated pneumonia after using breathing machine.The occurrence of ventilator associated pneumonia is not only prolonging the patient's hospital stay,but also one of the important factors of death.During mechanical ventilation,patients often appear agitated discomfort,man-machine confrontation etc.So it needs use sedative drugs through the mechanical ventilation.Long calm suppression control patients cough reflex,affect airway secretions and increase the risk of lung infection.The occurrence of ventilator associated pneumonia has close relationship with calm treatment.At present,the ICU exist widespread inappropriate calm.It is important topic in clinical that how to achieve the ideal calm.ObjectivesInvestigate ICU mechanical ventilation in patients with ventilator associated pneumonia(VAP)and sedation therapy related factors.provide guidance for reasonable application of sedatives mechanical ventilation patients,so as to prevent various complications of depressant,through to improve the composed strategy,reduce the occurrence of VAP and reduce the case fatality rate.MethodsThis research used a retrospective investigation which about 218 patients using sedatives and mechanical ventilation at the same time from July 2014 until June 2016 in a third-grade class-A hospital.Ventilator used for more than 48 hours.No pulmonary infection before mechanical ventilation.All use intravenous continuous pumping of propofol or Yuelixi and adopting RASS sedation to make a score.Clinical nursing assessment:blood pressure,heart rate,blood oxygen saturation,breathing,etc.According to the inclusion criteria and exclusion criteria to determine the research object.First,input "breathing machine help breathing" in ICU nurse workstation computer system in a third-grade class-A hospital,the time selected from July 2014 to June 2016.571 patients with mechanical ventilation were detected.According to the set terms and conditions "patients with mechanical ventilation more than 48 hours" bring into the research object.The preliminary screen out the patients with mechanical ventilation more than 48 hours has 302 cases.And then according to the condition "patients with mechanical ventilation and using sedative drugs at the same time" and eliminating interference,and the patients who are not conform to the standard.At last screen out patients with mechanical ventilation and using sedative drugs at the same time have 218 cases statistics of 218 patients with mechanical ventilation calm time,sedation score,mechanical ventilation time and living ICU time.Group according to VAP occurs or not.If occurs VAP,it is the observation group.If no occurs VAP,it is control group.Compare with the difference between two groups of patients in a calm time,sedation scores,mechanical ventilation and living ICU time.ResultsVAP occurrence:in 218 patients with mechanical ventilation,61occured VAP(27.98%)?157 no occur VAP(72.02%).About two groups of patients age,sex,heart rate,breathing rate,mean arterial pressure and Acute Physiology and Chronic Health Evaluation,APACHE ? score,there was no statistically significant difference.(P>0.05).Two groups of patients in the prevention of ventilator associated pneumonia cluster strategy measures are consistent,so the two groups are comparable.Observation group 61 patients all calm time is 7.51±7.86 days,sedation score is-2.69±1.09,mechanical ventilation time is 8.52±17.11days,living ICU time is 24.44±21.93 days.Control croup 157 patients calm time is 3.83±2.91 days,sedation time is-1.22±1.52,mechanical ventilation time is 6.47±5.70 days,living ICU time is 11.63±7.49 days.There was statistically significant difference(P<0.01).ConclusionAccording to the clinic data of 218 patients,who using sedatives and mechanical ventilation at the same time,to analyze the related factors between mechanical ventilation associated pneumonia and calm treatment.The research shown that patients with mechanical ventilation calm time,depth and VAP were positively correlated,thus it provides the basis in the clinical management for mechanical ventilation and how to reduce the occurrence of ventilator associated pneumonia,through on sedation strategies to improve and reduce the incidence of VAP.