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Ventilator-associated pneumonia in adult intensive care unit prevalence and complications
Author(s) -
Ahmed Abdelrazik Othman,
Mohsen Salah Abdelazim
Publication year - 2017
Publication title -
egyptian journal of critical care medicine /egyptian journal of critical care medicine
Language(s) - English
Resource type - Journals
eISSN - 2090-9209
pISSN - 2090-7303
DOI - 10.1016/j.ejccm.2017.06.001
Subject(s) - medicine , ards , pneumonia , ventilator associated pneumonia , mechanical ventilation , intensive care unit , atelectasis , septic shock , sepsis , intensive care medicine , exacerbation , intensive care , lung
Background: Ventilator-associated pneumonia (VAP) remains a common cause of intensive care unit (ICU) and hospital morbidity and mortality despite advances in diagnostic techniques and management. We aimed to determine the prevalence, possible complications and in-hospital prognosis of VAP in mechanically ventilated patients.Methods: This prospective observational, case-control study, was carried out from September 2012 to August 2013. Forty-eight adult patients maintained on mechanical ventilation for more than 48 h in our ICU were enrolled in the study. VAP was diagnosed as new persistent pulmonary infiltrates on chest radiographs and, at least two of following: (1) fever of ≥38.3 °C, (2) leukocytosis of ≥12,000⧹mm3, and (3) purulent tracheobronchial secretions. Endotracheal aspirate (ETA) samples of suspected cases were collected and processed as per standard protocols.Results: The primary underlying diagnosis was acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in 25 patients, congestive heart failure in 10, pneumonia in 6, post-operative in 5, neurological diseases in 2 patients. VAP developed in 17 patients (35.4%), gram-negative agents were the major offending pathogen (Pseudomonas aeruginosa accounting for 22.9%). The length of ventilation (LOV) and the length of ICU stay (LOSICU) were significantly higher in the VAP group (P = 0.001, 0.0001 respectively). Severe sepsis/septic shock, acute respiratory distress syndrome (ARDS), atelectasis, and infection with multi-drug resistant organisms were more common in the VAP group. Conclusion: Ventilator-associated pneumonia was associated with a significant increase in ICU length of stay, time on mechanical ventilation and different complications

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