Clinical study of ventilated-associated pneumonia after cardiac surgery in adults
10.3760/cma.j.issn.1672-7088.2019.17.011
- VernacularTitle: 基于德尔菲法的成人心脏术后呼吸机相关性肺炎的相关因素研究
- Author:
Jiaohua YU
1
;
Mengyuan LI
2
;
Hui KE
3
;
Huan WANG
4
;
Xuehui ZHANG
5
;
Xinghong LIU
6
;
Shiyu ZHAO
2
;
Yunfang LIU
2
Author Information
1. Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
2. Graduate School of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
3. Department of Hepatobiliary Surgery of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
4. Department of Neurosurgery of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
5. Cancer Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
6. Department of Cardiac Surgery of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Publication Type:Journal Article
- Keywords:
Adults;
Major heart surgery;
Ventilator-associated pneumonia;
Delphi;
Clinical study
- From:
Chinese Journal of Practical Nursing
2019;35(17):1324-1329
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the epidemiological data of ventilator-associated pneumonia(VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients.
Methods:Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed.
Results:Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively; Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48%. Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors.
Conclusions:The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care
