Effect of ε-polysine intervention on ventilator associated pneumonia in children with mechanical ventilation in pediatric intensive care unit
10.3760/cma.j.issn.1672-7088.2019.19.008
- VernacularTitle: ε-聚赖氨酸干预法对儿科重症监护室机械通气患儿呼吸机相关性肺炎的影响
- Author:
Zhiwei WU
1
Author Information
1. Department of PICU, Xinyang Central Hospital, Henan Province, Xinyang 464000, China
- Publication Type:Clinical Trail
- Keywords:
Ventilator associated pneumonia;
Mechanical ventilation;
Intensive care unit;
Pipeline bacterial colonization;
ε
-polysine
- From:
Chinese Journal of Practical Nursing
2019;35(19):1474-1477
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of ε-polylysine intervention on the incidence of ventilator-associated pneumonia (VAP), the time of mechanical ventilation and bacterial colonization in pediatric intensive care unit (PICU) patients with mechanical ventilation.
Methods:A total of 80 cases of mechanical ventilation with PICU were selected from our hospital between January 2016 and June 2018. All the children were randomly divided into group a, group b and group c, among which group a had three daily interventions, group b had two daily interventions, and group c had no intervention. The incidence of VAP in each group was monitored, the time of mechanical ventilation was recorded, and the results of bacterial culture in different parts of ventilator pipes were compared.
Results:The mechanical ventilation time of the two groups was (4.82±0.39) d and (5.49±0.68) d, both significantly lower than that of group c (7.40±0.43) d (t=-2.384, -1.836, P < 0.05). VAP incidence was 7.41% (2/27) and 29.63%(8/27), respectively, in group a and group b, both significantly lower than 69.23% (18/26) in group c (χ2=22.193, 9.384, all P < 0.05). The mechanical ventilation time of group a was significantly lower than that of group b (P < 0.05), and there was no significant difference in the incidence of VAP between the two groups (P > 0.05). Three groups of children wetting tank, threaded pipe outlet interface, threaded pipe inlet interface of bacterial culture almost no pollution; On the 4th day of operation, the positive rate of bacteria at the Y junction and the condensate at the outlet and the condensate at the inlet was significantly lower in group a than in group c (χ2=39.384, 20.384, 10.282, P < 0.05). The positive rate of y-type interface bacteria in group b was significantly lower than that in group c (χ2=10.152, P < 0.05). On the 7th day of operation, the positive rate of bacteria at Y junction, outlet condensate and inlet condensate in group a was significantly lower than that in group c (χ2=21.023, 5.340, 7.495, P < 0.05). The positive rate of Y junction, outlet condensate and inlet condensate in group b was significantly lower than that in group c (χ2=6.954, 11.203, 13.023, P < 0.05).
Conclusions:The intervention of ε-polylysine in children with PICU mechanical ventilation can cut off the exogenous infection pathway, effectively inhibit the growth of bacterial colonization, shorten the time of mechanical ventilation and reduce the incidence of VAP in children. It is worthy of being popularized in clinic.
