Choi Jeong-Sil, Yeon Jeong-haw
Department of Nursing Science, Sangji University, 660 Usan-dong, Wonju 220-702, Korea.
J Korean Acad Nurs. 2010 Dec;40(6):799-807. doi: 10.4040/jkan.2010.40.6.799.
To determine whether the practice of not routinely changing ventilator circuits in patients who require prolonged mechanical ventilation is associated with ventilator-associated pneumonia (VAP).
Patients were divided into two groups, ventilator circuits were routinely changed every 7 days for the control group (39) and every 14 days for the experimental group (40) over a period of 1 yr (April 1, 2009-March 31, 2010). Pediatric patients (age 17 yr or less) were not included. VAP was diagnosed by the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of VAP and characteristics of infection were evaluated.
In the experimental group, 2 episodes of pneumonia were observed in 40 patients and 1,322 ventilator days. The rate of VAP was 1.5 per 1,000 ventilator days. There was 1 episode of pneumonia in 39 patients and 481 ventilator days for the control group. The rate of VAP was 2.1 per 1,000 ventilator days. The difference between both groups was not significant (p=.695).
Extending ventilator circuit change interval from 7 days to 14 days does not increase the risk for VAP.
确定对于需要长期机械通气的患者不常规更换通气回路的做法是否与呼吸机相关性肺炎（VAP）有关。
将患者分为两组，在1年期间（2009年4月1日至2010年3月31日），对照组（39例）通气回路每7天常规更换一次，实验组（40例）每14天更换一次。不纳入儿科患者（17岁及以下）。VAP根据疾病控制与预防中心（CDC）的标准进行诊断。评估VAP的发生率和感染特征。
实验组40例患者在1322个机械通气日中观察到2例肺炎。VAP发生率为每1000个机械通气日1.5例。对照组39例患者在481个机械通气日中有1例肺炎。VAP发生率为每1000个机械通气日2.1例。两组之间差异无统计学意义（p = 0.695）。
将通气回路更换间隔从7天延长至14天不会增加VAP风险。
