Triamvisit Suphannee, Maneewan Chatchanee, Bunturat Prapassorn, Wongprasert Wassana, Limpassatan Kriengsak, Kasatpibal Nongyao, Euathrongchit Juntima
J Med Assoc Thai. 2016 Sep;99(9):1014-9.
Ventilator-associated pneumonia (VAP) is the most common intensive care unit-acquired infection, resulting in increased morbidity and mortality as well as increased hospital costs.
To determine the VAP rate before and after using the care bundle.
A pre- and intervention study was conducted in the Neurosurgical Critical Care Unit (NCCU) at a university hospital between April 2012 and February 2013. This was compared with the twelve-month period before intervention. The six-element VAP prevention bundle called Suandok Model was implemented. It included 30-degree head elevation, bedside hand hygiene, oral chlorhexidine mouth care, inflating of the cuff of the endotracheal tube maintaining 20 to 25 mmHg, checking residual gastric content before feeding, and implementing a weaning protocol.
The samples before and after interventions were 66 and 68 cases, respectively. There were no significant differences between sex, age, GCS, diagnosis, and operation. The incidence rates of VAP in the intervention period showed a significant decrease (p = 0.001, 39.55 per 1,000 ventilator days vs. 13.30 per 1,000 ventilator days).
The Suandok Model reduced VAP in NCCU patients.
呼吸机相关性肺炎（VAP）是重症监护病房获得性感染中最常见的类型，会导致发病率和死亡率上升以及医院成本增加。
确定使用护理集束方案前后的VAP发生率。
2012年4月至2013年2月期间，在一所大学医院的神经外科重症监护病房（NCCU）进行了一项干预前和干预研究。将其与干预前的十二个月期间进行比较。实施了名为Suandok模型的六要素VAP预防护理集束方案。该方案包括床头抬高30度、床边手部卫生、口腔氯己定口腔护理、将气管内导管的气囊充气至维持20至25 mmHg、喂食前检查胃残余量以及实施撤机方案。
干预前后的样本分别为66例和68例。性别、年龄、格拉斯哥昏迷量表（GCS）、诊断和手术方面均无显著差异。干预期间VAP的发生率显著降低（p = 0.001，每1000个呼吸机日39.55例 vs. 每1000个呼吸机日13.30例）。
Suandok模型降低了NCCU患者的VAP发生率。
