发展中国家一家儿科重症监护病房中呼吸机集束干预措施的实施
Implementation of Ventilator Bundle in Pediatric Intensive Care Unit of a Developing Country.
作者信息
Haque Anwarul, Riaz Quratulain, Ali Syed Asad
机构信息
Department of Pediatrics and Child Health, The Aga Khan University Hospital, Karachi.
出版信息
J Coll Physicians Surg Pak. 2017 May;27(5):316-318.
The aim of this study was to assess the frequency of VAP(ventilator associated pneumonia) after strict implementation of ventilator bundle in PICU. Medical records of all children (age 1 month - 16 years) were retrospectively reviewed, who were on mechanical ventilation (MV) for more than 48 hours and received all key components of "ventilator bundle" from January 2012 to December 2014. Out of 1050, 565 (54%) patients were enrolled. The mean age was 4.02 SD 4.29 years and 62 (69%) were male. The indications of MV were respiratory illness (54%), neurological illness (31%), shock (9%), and postoperative care (6%). The mean duration of MV was 7.05 SD 5.4 days. Only 4 patients (0.7%) developed VAP. The incidence-density of VAP was 1.6 per 1000 ventilator days. The strict implementation of simple, inexpensive interventions (ventilator bundle) in care of mechanically ventilated children can decrease significantly VAP even in resource-limited country.
本研究的目的是评估在儿科重症监护病房（PICU）严格实施呼吸机集束化治疗措施后呼吸机相关性肺炎（VAP）的发生频率。对2012年1月至2014年12月期间所有接受机械通气（MV）超过48小时且接受了“呼吸机集束化治疗措施”所有关键组成部分的儿童（年龄1个月至16岁）的病历进行了回顾性分析。在1050例患儿中，565例（54%）被纳入研究。平均年龄为4.02±4.29岁，62例（69%）为男性。机械通气的指征包括呼吸系统疾病（54%）、神经系统疾病（31%）、休克（9%）和术后护理（6%）。机械通气的平均持续时间为7.05±5.4天。只有4例患者（0.7%）发生了VAP。VAP的发病密度为每1000呼吸机日1.6例。在机械通气儿童的护理中严格实施简单、廉价的干预措施（呼吸机集束化治疗措施），即使在资源有限的国家也能显著降低VAP的发生率。
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