输管患者呼吸机相关事件的流行病学:一个多中心观察性研究
Esma Eryılmaz Eren1, Duygu Mert2, Fatma Eser3
1Department of Infectious Disease and Clinical Microbiology, Kayseri City Training and Research Hospital, University of Health Sciences, 38080, Kayseri, Turkey. esmaereneryilmaz@gmail.com.
BMC infectious diseases
|October 22, 2025
概括
呼吸器相关事件 (VAE) 在ICU患者中很常见,并增加死亡风险. 识别高SOFA分数和气管切除术等风险因素对于预防VAE和改善患者生存至关重要.
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
- 流行病学 流行病学
背景情况:
- 医疗相关感染 (HAI) 是重症监护室 (ICU) 的一个重要问题.
- 呼吸器相关事件 (VAE) 监测已经取代了传统的呼吸器相关肺炎 (VAP) 监测.
- 关于VAE的流行病学,病因学和预后的数据有限.
研究的目的:
- 描述VAE的流行病学.
- 为了确定VAE的病因.
- 为了阐明VAE的预后.
主要方法:
- 多中心观察描述性研究,预期90天的VAE监测.
- 使用2015年CDC指南对VAE定义,包括VAC,IVAC-plus,IVAC和PVAP等亚诊断.
- 使用多变量分析分析了VAE和死亡率的风险因素.
主要成果:
- 在1018名患者中,有174人发生了185次VAE;每1000个机械通风日的VAE发病率为VAC 2.33,IVAC-plus 6.0,IVAC 1.3和PVAP 4.7.
- 85个VAP事件 (45.9%) 符合并发的VAE标准.
- VAE的危险因素包括SOFA分数>7,气管管切除术和最近使用抗生素. 死亡风险因素包括年龄>63,SOFA评分>5,高查尔森并发症指数,医疗患者类型,HAI和VAE发生.
结论:
- VAE是直管患者常见的并发症,与死亡的可能性增加2.21倍有关.
- 高SOFA分数,气管切除术和最近使用抗生素是VAE的重要危险因素.
- 预防VAE对于改善直管患者的生存率至关重要.
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