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Frequency of Ventilator Associated Pneumonias in Patients in the Intensive Care Unit
Ismet Suljevic1, Denis Asotic2, Ismana Surkovic3
1Clinic for Anesthesia and Resuscitation, Clinical Center Sarajevo, Bosnia and Herzegovina.
Introduction:
Ventilator associated pneumonia (VAP) is defined as nosocomial pneumonia in patients who have mechanical ventilation (MV) for more than 48 hours. The diagnosis of VAP is based on radiological-microbiological examinations. In the United States, the Centers for Disease Control and Prevention (CDC) and the National Health Care Network (NHSN) have an incidence of VAP of 5.8% per 1,000 days on mechanical ventilator.
Aim:
In this study, we had an aim to determine the occurrence of ventilator-associated pneumonia (VAP) in patients with MV who were hospitalized in the intensive care unit.
Method:
The study was retrospective, clinical, conducted in the period from January 1, 2016 until December 31, 2016. In a one-year period, 719 patients of both sex, aged 14 to 91, were hospitalized in the intensive care unit of the Clinic for Anesthesia and Resuscitation of the University Clinical Center in Sarajevo. The study included 250 patients of both sex who had respiratory support with mechanical ventilator. No patient was excluded from the study. As a confirmation of VAP, we used microbiological reports from the patient history documentation. The results were presented statistically through tables and graphs, numerically, by a percentage, and by a mean value with standard deviation.
Results:
Out of the 719 hospitalized patients, 250 or 34.8% underwent controlled ventilation. In 103 or 41.2% of patients some form of pneumonia was confirmed microbiologically. An average patient age on controlled ventilation was 60.4 ± 16.8 years. The mean age of a female patients who were on controlled ventilation was 63.2 ± 16.7, higher than that of male patients, which was 57.8 ± 16.6 years. The most frequent patients were over 60 years of age (52.8%). The shortest hospitalization of patients on controlled mechanical ventilation was 1 day and the longest was 120 days. Average duration of mechanical ventilation was 6.9 ± 10.5 days.
Conclusion:
VAP is a relatively common complication in patients with MV that can increase morbidity and mortality, as well as treatment costs. It is more frequent in females and in the elderly. Medical staff should provide normal maintenance of respiratory functions to a patient who is on MV, which will reduce the risk of VAP.
Insights
Ventilator-associated pneumonia (VAP) occurred in 41.2% of patients on mechanical ventilation (MV). This common complication is more prevalent in elderly females and increases healthcare costs, underscoring the need for vigilant respiratory care.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pulmonology
Background:
- Ventilator-associated pneumonia (VAP) is a significant nosocomial infection in patients requiring mechanical ventilation (MV) for over 48 hours.
- Diagnosis relies on radiological and microbiological evidence, with reported incidences varying across healthcare settings.
- The Centers for Disease Control and Prevention (CDC) notes VAP incidence at 5.8% per 1,000 days on MV in the US.
Purpose of the Study:
- To determine the occurrence rate of VAP among intensive care unit (ICU) patients receiving mechanical ventilation.
- To analyze demographic factors associated with VAP in this patient population.
Main Methods:
- A retrospective clinical study was conducted over one year (January 1, 2016 - December 31, 2016).
- Data was collected from 719 ICU patients, focusing on 250 who received mechanical ventilation.
- VAP confirmation utilized microbiological reports from patient records; statistical analysis included percentages and mean values.
Main Results:
- Out of 719 hospitalized patients, 250 (34.8%) required mechanical ventilation.
- Microbiological confirmation of VAP was found in 103 (41.2%) of the ventilated patients.
- The average age of patients on mechanical ventilation was 60.4 years, with a higher incidence in females (63.2 years) and individuals over 60 (52.8%). Average ventilation duration was 6.9 days.
Conclusions:
- VAP is a common complication in mechanically ventilated patients, associated with increased morbidity, mortality, and treatment costs.
- The study indicates VAP is more frequent in elderly females.
- Maintaining optimal respiratory function is crucial for reducing VAP risk in patients on MV.
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