Construction and clinical practice of vector management strategy for preventing ventilator-associated pneumonia by blocking etiological characteristics
10.3760/cma.j.cn211501-20230905-00467
- VernacularTitle:阻断病原学特性预防呼吸机相关性肺炎媒介管理策略构建与临床实践
- Author:
Xinhua XIA
1
;
Ying WANG
;
Pengbo YAN
;
Yanling SUN
;
Meimei SI
;
Lie QIN
;
Yuxia WANG
;
Yanan LI
;
Ling CHEN
;
Zijun ZHANG
Author Information
1. 天津市泰达医院护理部，天津 300457
- Keywords:
Respiration, artificial;
Pneumonia, ventilator-associated;
Pathogen;
Vector;
Care strategies
- From:
Chinese Journal of Practical Nursing
2024;40(4):283-288
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish an environmental management strategy for the prevention of ventilator-associated pneumonia from the perspective of etiological characteristics and to verify its application effect.Methods:Based on a sampling survey, this study constructed preventive management strategies for ventilator-associated pneumonia by blocking pathogen characteristics from the perspective of both colonization and infection management in patients. From July 2021 to June 2023, a non-synchronous randomized controlled study was conducted, including a control group of 59 cases and an experimental group of 57 cases from ICU of Tianjin Teda Hospital, all of them were mechanically ventilated patients. The effectiveness of the strategy was confirmed.Results:In the control group, there were 35 males and 24 females, with an average age of (46.97 ± 18.84) years. In the experimental group, there were 39 males and 18 females, with an average age of (47.49 ± 13.85) years. During the study period, there were 9 cases of ventilator-associated pneumonia (VAP) in the control group and 2 cases in the experimental group, the difference between the two groups was statistically significant (exact odds ratio=0.031). The duration of mechanical ventilation in the experimental group (122.41 ± 18.36) h, which was shorter than that in the control group (187.62 ± 18.05) h, and the difference was statistically significant ( t=19.28, P<0.05). The length of ICU stay in the experimental group was (8.38 ± 0.79) d, in the control group was (10.99 ± 1.10) d, the difference between them was statistically significant ( t=14.66, P<0.05). On the 7th day, there were 7 cases of positive pathogenic bacteria in sputum culture in the experimental group, which was significantly different from the 29 cases in the control group ( χ2=16.73, P<0.05). Conclusions:The vector management strategy for preventing ventilator-associated pneumonia by blocking etiological characteristics can reduce the incidence of VAP, shorten the duration of mechanical ventilation and ICU stay, and reduce the pathogen load in the sputum of mechanically ventilated patients on the 7th day.
