Effect of comprehensive interventions to pulmonary rehabilitation on prevention of ventilator-associated pneumonia in elderly patients undergoing long-term mechanical ventilation
10.11816/cn.ni.2025-251162
- VernacularTitle:长期机械通气高龄患者肺康复综合干预方案及其对呼吸机相关肺炎的预防效果
- Author:
Jionghe WU
1
;
Dan WANG
;
Jiangqiong SHEN
;
Dongmei LI
;
Jing ZHAO
Author Information
1. 中国人民解放军总医院第二医学中心呼吸与危重症医学科,北京 100853;国家老年疾病临床研究中心,北京 100853;解放军医学院,北京 100853
- Publication Type:Journal Article
- Keywords:
Long-term mechanical ventilation;
Elderly;
Pulmonary rehabilitation;
Functional training;
Ventilator-associated pneumonia
- From:
Chinese Journal of Nosocomiology
2025;35(22):3378-3382
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the effect of comprehensive interventions to pulmonary rehabilitation on preven-tion of ventilator-associated pneumonia(VAP)in elderly patients undergoing long-term mechanical ventilation.METHODS A total of 154 elderly patients(aged no less than 80 years old)who received long-term me-chanical ventilation(no less than 21 days)in the Second Medical Center of Chinese PLA General Hospital from Nov.2018 to Dec.2024 were recruited as the research subjects and were randomly divided into the comprehen-sive intervention group with 77 cases(routine nursing plus comprehensive interventions to pulmonary rehabilita-tion)and the routine nursing group with 77 cases.RESULTS The incidence of VAP was 12.31％in the comprehen-sive intervention group,30.65％in the routine nursing group(P=0.009);the off-ventilator oxyhemoglobin satu-ration was(92.29±5.78)％in the comprehensive intervention group at the end of observation period,(88.84±4.70)％in the routine nursing group(P＜0.001);the diaphragmatic thickening ratio was(36.78±16.06)％in the comprehensive intervention group,(25.02±19.97)％in the routine nursing group(P＜0.001);the 24-hour ex-pectoration volume was(94.68±26.65)ml in the comprehensive intervention group,(64.61±15.16)ml in the routine nursing group(P＜0.001);all the above indexes were improved.The result of multivariate logistic regres-sion analysis showed that no interventions to pulmonary rehabilitation(OR=2.763,95％CI:1.061 to 7.195)and mechanical ventilation(OR=1.107,95％CI:1.033 to 1.186)were the risk factors for VAP(P＜0.05).CONCLUSIONS The comprehensive interventions to pulmonary rehabilitation can remarkably improve the respira-tory function of the elderly patients undergoing mechanical ventilation and reduce the incidence of VAP.The ex-tension of mechanical ventilation may increase the risk of VAP.
