Clinical research of ε-polylysine in the prevention of ventilator-associated pneumonia for children with mechanical ventilation in PICU
10.3760/j.issn.1674-2907.2015.03.001
- VernacularTitle:ε-聚赖氨酸预防儿科重症监护室机械通气患儿呼吸机相关性肺炎的效果研究
- Author:
Xinxin ZHANG
1
;
Zelan ZUO
Author Information
1. 100045 首都医科大学附属北京儿童医院NICU
- Keywords:
Pneumonia,ventilator-associated;
Intensive care units,pediatric;
ε-polylysine;
Respiration,artificial
- From:
Chinese Journal of Modern Nursing
2015;21(3):249-253
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of ε-polylysine to prevent ventilator-associated pneumonia ( VAP) for children with mechanical ventilation in Pediatric Intensive Care Unit ( PICU ) and to provide evidence-based procedure for clinical VAP prevention.Methods A total of ninety children with mechanical ventilation in PICU from January to September in 2012 were randomly divided into three groups averagely:experimental group A and B (3 timesε-polylysine intervention daily as group A,2 timesε-polylysine intervention daily as group B) and control group ( non-ε-polylysine-intervention as group C) .All cases had been numbered by time sequence.ε-polylysine was sprayed to Y-interface.The incidences of VAP were targeted monitored, and sampling bacteria on lower respiratory tract and various parts of ventilator tubing ( thread-inlet end and outlet end interface, condensate of inlet and outlet section, Y-type interface, wet tank) had been isolated, cultured and counted.Results The rates of VAP were 10%, 30%and 70%respectively in group A, B and C (χ2 =24.115;P<0.01), while the time of mechanical ventilation in three groups were (4.2 ±0.4), (5.2 ±0.7) and (7.1 ±0.3)h (F=260.953;P<0.01).In the fourth day and seventh day, we compared the numbers of bacteria in children′s respiration and tube for air admission, tube for air outlet and Y-type interface indicated statistical significance (χ2 =12.115-34.658,P<0.01).On the fourth day and fifth to eighth day, we compared children patients′bacteria amount in condensate water for ventilator′s air inlet and outlet in three groups, it showed that they had statistical significance (χ2 =12.604 -47.624;P <0.01). Conclusions The use of 28 μg/ml ε-polylysine 3 times daily can effectively control bacterial colonization in ventilator tubing, cut off infection from exogenous route, reduce the incidence of VAP, shorten mechanical ventilation time and improve the prognosis, and make more important guiding significance on clinical nursing.
