scholarly journals Incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients

2018 ◽  
Vol 6 (8) ◽  
pp. 2754
Author(s):  
David D. M. Rosario ◽  
Anitha Sequeira
Keyword(s):  
Mechanical Ventilation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Early Tracheostomy ◽  
Hospital Acquired Infection ◽  
Total Incidence ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Background: Pneumonia is the most common hospital acquired infection in the intensive care unit. One of the causes for hospital acquired pneumonia is ventilator associated pneumonia. Tracheostomy is known to prevent occurrence of ventilator associated pneumonia as it decreases the respiratory dead space, assists in better clearance of secretions and prevents chances of aspiration. Generally, tracheostomy is done after 2 weeks of endotracheal intubation to prevent tracheal complications. The aim of this study is to identify the incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients and to see if early tracheostomy can prevent development of ventilator associated pneumonia.Methods: The study was conducted at a tertiary care hospital during a period of four years. 100 patients who were on mechanical ventilation for more than 7 days where taken up for the study. APACHE 4 scoring system was used. The incidence of Ventilator associated pneumonia in tracheostomised and non tracheostomised patients was studied.Results: In our study the total incidence of VAP was 44 %. In our study out of the 42 patients who had undergone tracheostomy 13 (30.95%) patients had ventilator associated pneumonia. Among the non-tracheostomised patients 31 (53.44%) out of 58 patients developed ventilator associated pneumonia. In our study the incidence of ventilator associated pneumonia was much lesser (12%) in patients who underwent tracheostomy in the period 7 to 10 days after mechanical ventilation, whereas in those who underwent tracheostomy after 11 days incidence of ventilator associated pneumonia was much higher.Conclusions: Our study showed that the incidence of ventilator associated pneumonia was much higher among non tracheostomised patients compared to patients who underwent tracheostomy. Hence patients undergoing earlier tracheostomy had a clear advantage than those undergoing tracheostomy late or non tracheostomised patients in preventing ventilator associated pneumonia.

scholarly journals Lack of bundled care intervention training program will trip up rates of ventilator associated pneumonia: the contemporary trend

2019 ◽  
Vol 6 (6) ◽  
pp. 2623
Author(s):  
Rituja Kaushal ◽  
Sanjeev Gupta ◽  
Aashish Saraogi ◽  
Sandhya Singh
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Secondary Data ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Hospital Acquired Infection ◽  
Intervention Training ◽  
Care Intervention ◽  
Hospital Acquired

Background: Ventilator associated pneumonia (VAP) is the deadliest hospital acquired infection in many low resource settings of developing countries. For VAP prevention, the concept of bundle of care was defined. Evidence based resources showed it enabled great successes in VAP prevention. It has been observed in clinical practice due to insufficient compliance, there is a need to address related issues in order to define easier-to-apply procedures.Methods: It is a retrospective analytical secondary data based study. It was conducted in a tertiary care hospital of Bhopal city.Results: T value of Mann Whitney/U test was found to be statistically significant and is indicating need of “Bundle Care Intervention” training for the prevention of increase in ventilator associated pneumonia rates in any health care setting.Conclusions: Expanded bevy of options related to infect

Epidemiology and clinical outcome of ventilator-associated events at a tertiary care hospital from North India

2020 ◽  
pp. 004947552098245
Author(s):  
Pooja Kumari ◽  
Priya Datta ◽  
Satinder Gombar ◽  
Deepak Sharma ◽  
Jagdish Chander
Keyword(s):  
Mechanical Ventilation ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Control Measures ◽  
North India ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Utilisation Rate

The aim of our study was to determine the incidence, microbiological profile, risk factors and outcomes of patients diagnosed with ventilator-associated events in our tertiary care hospital. In this prospective study, intensive care patients put on mechanical ventilation for >48 h were enrolled and monitored daily for ventilator-associated event according to Disease Centre Control guidelines. A ventilator-associated event developed in 33/250 (13.2%); its incidence was 3.5/100 mechanical ventilation days. The device utilisation rate was 0.86, 36.4% of patients had early and 63.6% late-onset ventilator-associated pneumonia whose most common causative pathogen was Acinetobacter sp. (63.6%). Various factors were significantly associated with a ventilator-associated event: male gender, COPD, smoking, >2 underlying diseases, chronic kidney disease and elevated acute physiological and chronic health evaluation II scores. Therefore, stringent implementation of infection control measures is necessary to control ventilator-associated pneumonia in critical care units.

scholarly journals A study on poor prognostic factors associated with ventilator associated pneumonia at a tertiary care hospital

2020 ◽  
Vol 7 (6) ◽  
pp. 906
Author(s):  
Raveendra K. R. ◽  
Suraj S. Hegde
Keyword(s):  
Mechanical Ventilation ◽  
Prognostic Factors ◽  
Late Onset ◽  
Tertiary Care ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Cross Sectional ◽  
Beta Lactamases ◽  
Factors Associated ◽  
Hospital Acquired

Background: Ventilator associated pneumonia (VAP) is a hospital acquired infection (HAI) seen among critically ill patients, on mechanical ventilation, due to various causes in intensive care units (ICUs). It is associated with increased morbidity and mortality which increases the cost of health care. The aim of this study was to determine the poor prognostic factors associated with VAP.Methods: In this cross-sectional prospective study,40 patients who developed features of ventilator associated pneumonia on a platform of mechanical ventilator for >48 hrs in ICU were included in the study. VAP was then diagnosed based on clinical pulmonary infection scoring system (CPIS) with a score of >=6. All patients were evaluated and correlated with different parameters for the treatment and outcome.Results: Most of the patients had late onset VAP (60.7%) with average number of days being around 8 days. Pseudomonas, Acinetobacter, Enterobacteriacea, Staphylococcus aureus were commonly isolated organisms. Polymicrobial infections were not detected. Antibiotics like colistin, tigecycline and beta-lactamases are the most commonly effective antibiotics. Of the 40 VAP patients,20 patients survived and  20 died with protocol line of treatment. Following poor prognostic factors were identified-Early onset VAP (42.5%), elderly patients (>65 years) (90%), Type 2 DM (80%), hypertension (70%), prior antibiotic therapy (65%), prolonged supine position (68%) and re-intubation (75%).Conclusions: Ventilator associated pneumonia is associated with a significant increase in length of stay in ICU, time of mechanical ventilation and different complications and certain risk factors further worsens the prognosis.

scholarly journals Spectrum of Early Onset and Late Onset Ventilator Associated Pneumonia (VAP) in a Tertiary Care Hospital of Bangladesh: A Prospective Cohort Study

2015 ◽  
Vol 3 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Uzzwal Kumar Mallick ◽  
Mohammad Omar Faruq ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Early Onset ◽  
Prospective Cohort ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital

Objective : To compare the outcome of critically ill patients developing early onset Ventilator-associated pneumonia (VAP) occurring within 96 h of ICU admission and late onset VAP occurring after 96 h of ICU admission in critically ill patients admitted in the ICU of BIRDEM General Hospital of Bangladesh.Study Design: Prospective cohort study.Material and Methods: Study data obtained over a period of 24 months (July 2012 - June 2014) in the ICU of a tertiary care hospital was prospectively analyzed. Subjects were classified by ventilator status: early onset VAP (< 96 hrs of mechanical ventilation) or late-onset VAP (?96 hrs of mechanical ventilation). Baseline demographics and bacterial etiology were analyzed according to the spectrum of status of VAP.Results: The incidence of VAP was 35.73 per 1,000 ventilator days. In our study 52% of the cases were early-onset VAP, while 48% were late-onset VAP. Acinetobacter was the commonest organism isolated from late-onset VAP (p = 0.029) while Pseudomonas was the commonest isolates obtained from early-onset VAP (p = 0.046). Klebsiella, MRSA and E. coli were almost identically distributed between groups (p > 0.05). There is significant difference of sensitivity pattern of Acinetobacter baumannii and pseudomonas aeruginosa in both early and late-onset VAP (p=0.01). The overall mortality rate in our study was 44%. The mortality was significantly higher in the late-onset VAP (62.5%) than that in the early-onset VAP (26.9%) (p=0.011).Conclusion: From this study we conclude that late-onset VAP had poor prognosis in terms of mortality as compared to the early-onset type. The higher mortality in the late-onset VAP could be attributed to older age, higher co-morbidities like diabetes mellitus, COPD and CKD. The findings are similar to findings of other international studiesBangladesh Crit Care J March 2015; 3 (1): 9-13

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