发生率,危险因素,微生物学和VAP的结果在印度的NCU:一个前性的观察性研究
Kapil Zirpe1, Upendra Kapse1, Akansha Sharma1
1Department of Neurotrauma, Ruby Hall Clinic, Grant Medical Foundation, Pune, Maharashtra, India.
概括
呼吸机相关性肺炎 (VAP) 影响了近25%的印度神经临床护理单位的通风患者. 关键的危险因素包括男性性别,低GCS,长时间通风和糖尿病,其中MDR有机体普遍存在.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 神经科学是一个神经科学.
背景情况:
- 呼吸机相关性肺炎 (VAP) 在神经临界护理单位 (NCU) 构成了重大挑战.
- 管理需要机械通风 (MV) 的危急病患者需要了解VAP流行病学.
- VAP的高发病率会影响在专门的神经重症监护机构的患者的治疗结果.
研究的目的:
- 为了确定印度NCU中VAP的发病率.
- 确定与VAP开发相关的重大风险因素.
- 分析微生物学,耐药性模式和VAP的结果.
主要方法:
- 前性,单中心,观察性研究设计.
- 使用CPIS标准对成人患者进行MV的查>48小时.
- 多变量分析以确定VAP风险因素并评估死亡率和LOS等结果.
主要成果:
- VAP发生率为24.94% (每1000个呼吸机日中有39.43).
- 显著的危险因素包括男性性别,低GCS (3-8),长时间通风和糖尿病.
- 常见的病原体是*Acinetobacter baumannii*,*Klebsiella pneumoniae*和*Pseudomonas aeruginosa*;81.58%是MDR和12.28%是XDR. 这两种病原体是最常见的.
- 与非VAP患者相比,VAP患者的ICU LOS较长,但死亡率相似.
结论:
- 在印度NCU中,VAP非常普遍,并确定了特定的风险因素.
- 在这种情况下,MDR和XDR生物体是VAP的常见原因.
- 虽然VAP增加了逗留时间,但其对死亡率的影响需要进一步调查.
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