Analysis of high risk factors and prognosis of patients with ventilator associated pneumonia treated with mechanical ventilation in ICU
10.3760/cma.j.issn.1008-6706.2019.12.006
- VernacularTitle: 重症医学科机械通气患者发生呼吸机相关性肺炎的高危因素及预后分析
- Author:
Jisheng XU
1
;
Hui YOU
;
Kai CHEN
Author Information
1. Department of ICU, Shaoxing Municipal Hospital, Shaoxing, Zhejiang 312000, China
- Publication Type:Journal Article
- Keywords:
Pneumonia, ventilator-associated;
Respiration, artificial;
Risk factor;
Prognosis;
Intensive care units;
Universal precautions;
Glucocorticoids;
Anti-bacterial agents;
Albumin
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(12):1433-1437
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the high risk factors and prognosis of patients with ventilator associated pneumonia(VAP) treated with mechanical ventilation(MV) in Intensive Care Unit(ICU), and to provide theoretical evidence for effective treatment and prevention.
Methods:From January 2015 to January 2017, 156 MV patients treated in ICU of Shaoxing Municipal Hospital were enrolled retrospectively.According to the occurrence of VAP, the patients were divided into VAP group(76 cases) and non-VAP group(80 cases). The data including sex, age, ICU time, MV time, cases of withdrawing machine failure, prognosis, serum albumin, blood glucose levels, APACHE Ⅱ score, types of antibiotics and days of continuous applying were recorded.Single factor χ2 test and multiple factor logistic regression analysis were used to analyze the high-risk factors and prognosis related to occurrence of VAP.
Results:Univariate analysis showed that the age, mortality, serum albumin and blood glucose levels, MV time, weaning failure rate, APACHE Ⅱ score, antibiotic combination type and days of continuous use, application of H2 receptor antagonists time between, the VAP group and non-VAP group had statistically significant differences (χ2=6.568, 16.558, 5.132, 5.896, 27.043, 15.018, 48.863, 46.752, 27.431, 3.981, P=0.010, 0.000, 0.023, 0.015, 0.000, 0.000, 0.000, 0.000, 0.000, 0.046). After age adjustment, logistic regression analysis showed that serum albumin <30g/L, blood glucose ≥7.8mmol/L, MV time >5 days, APACHE Ⅱ score>15 points, antibiotics continuous use>3 days, and antibiotic combination type>2 were independent risk factors for VAP(χ2=5.115, 5.984, 21.252, 18.043, 9.008, 14.545, P=0.030, 0.026, 0.000, 0.000, 0.007, 0.001). Compared with surviving patients with VAP, death patients lived longer in ICU and MV, and APACHE Ⅱ scores were higher(t=4.136, 6.382, 7.312, P=0.000, 0.000, 0.000).
Conclusion:There are multiple high-risk factors of VAP in patients treated with MV in ICU.The death demonstrated longer ICU time, MV time and higher APACHE Ⅱ score, need to be strengthened monitoring, early prevention and treatment.
