Hadda Vijay, Khilnani Gopi Chand, Dubey Gajendra, Nallan Rajkanna, Kumar Guresh, Guleria Randeep
Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Lung India. 2014 Jan;31(1):4-8. doi: 10.4103/0970-2113.125886.
There are sparse data regarding the impact of ventilator-associated pneumonia (VAP) on outcome among patients with chronic obstructive pulmonary disease (COPD) exacerbation.
This retrospective study included patients with COPD exacerbation requiring endotracheal intubation for more than 48 h admitted in a single respiratory unit from January 2008 to December 2009. Records of these patients were checked for the occurrence of VAP.
One hundred and fifty-three patients required endotracheal intubation for COPD exacerbation during this period. The mean age of this cohort was 61.46 ± 11.3 years. The median duration of COPD was 6 years (range: 1-40). A total of 35 (22.8%) patients developed VAP (early: 9 and late: 26). The risk of mortality was comparable between two groups, that is, patients with and without VAP [odd's ratio (OR)-1.125; 95% confidence interval (CI), 0.622-2.035]. The duration of mechanical ventilation and hospital stay (median ± standard error, 95% CI) was 32 ± 10 (95% CI, 13-51) versus 10 ± 2 (95% CI, 6-14) days; P ≤ 0.001 and 53 ± 26 (95% CI, 3-103) versus 18 ± 7 (95% CI, 5-31) days; P = 0.031, respectively was higher among patients with VAP.
Our study has shown that VAP leads to increased duration of mechanical ventilation and hospital stay; however, the mortality is not affected.
关于呼吸机相关性肺炎（VAP）对慢性阻塞性肺疾病（COPD）急性加重患者预后影响的数据较少。
这项回顾性研究纳入了2008年1月至2009年12月在单个呼吸科病房因COPD急性加重需要气管插管超过48小时的患者。检查这些患者的记录以确定VAP的发生情况。
在此期间，153例患者因COPD急性加重需要气管插管。该队列的平均年龄为61.46±11.3岁。COPD的中位病程为6年（范围：1 - 40年）。共有35例（22.8%）患者发生VAP（早期：9例，晚期：26例）。两组患者的死亡风险相当，即发生VAP和未发生VAP的患者[比值比（OR）- 1.125；95%置信区间（CI），0.622 - 2.035]。机械通气时间和住院时间（中位值±标准误，95%CI）在发生VAP的患者中分别为32±10（95%CI，13 - 51）天和53±26（95%CI，3 - 103）天，而在未发生VAP的患者中分别为10±2（95%CI，6 - 14）天和18±7（95%CI，5 - 31）天；P≤0.001和P = 0.031，发生VAP的患者中这些指标更高。
我们的研究表明，VAP会导致机械通气时间和住院时间延长；然而，死亡率不受影响。
