机械通气相关性肺炎的危险因素。
Risk Factors of Pneumonia Associated with Mechanical Ventilation.
机构信息
Department of Clinical Nursing, Faculty of Health Sciences, Jagiellonian University Collegium Medicum in Krakow, 31-501 Kraków, Poland.
University Hospital in Krakow, 31-001 Kraków, Poland.
出版信息
Int J Environ Res Public Health. 2020 Jan 19;17(2):656. doi: 10.3390/ijerph17020656.
The hospitalization of patients treated in the intensive care unit (ICU) in 5%-15% of cases is associated with the occurrence of a complication in the form of ventilator-associated pneumonia (VAP). Retrospective assessment of risk factors of VAP in patients treated at ICUs in the University Hospital in Krakow. The research involved the medical documentation of 1872 patients treated at the ICU of the University Hospital in Krakow between 2014 and 2017. The patients were mechanically ventilated for at least 48 h. The obtained data were presented by qualitative and quantitative analysis (%). The qualitative variables were compared using the test. Statistically significant was the < 0.05 value. VAP was demonstrated in 23% of all patients treated in ICU during the analyzed period, and this infection occurred in 13% of men and 10% of women. Pneumonia associated with ventilation was found primarily in patients staying in the ward for over 15 days and subjected to intratracheal intubation (17%). A statistically significant was found between VAP and co-morbidities, e.g., chronic obstructive pulmonary disease, diabetes, alcoholism, obesity, the occurrence of VAP and multi-organ trauma, hemorrhage/hemorrhagic shock, and fractures as the reasons for admitting ICU patients. Patients with comorbidities such as chronic obstructive pulmonary disease, obesity, diabetes, and alcoholism are a high-risk group for VAP. Particular attention should be paid to patients admitted to the ICU with multi-organ trauma, fractures, and hemorrhage/hemorrhagic shock as patients predisposed to VAP. There is a need for further research into risk factors for non-modifiable VAP such as comorbidities and reasons for ICU admission in order to allow closer monitoring of these patients for VAP.
在重症监护病房(ICU)接受治疗的患者中,有 5%-15%的患者会出现并发症,其中以呼吸机相关性肺炎(VAP)最为常见。回顾性评估了在克拉科夫大学医院 ICU 接受治疗的患者发生 VAP 的危险因素。该研究涉及了 2014 年至 2017 年期间在克拉科夫大学医院 ICU 接受治疗的 1872 名患者的医疗记录。这些患者至少接受了 48 小时的机械通气。通过定性和定量分析(%)来呈现获得的数据。使用 检验比较定性变量。统计显著性为 < 0.05。在分析期间,所有在 ICU 接受治疗的患者中有 23%被诊断为 VAP,其中 13%为男性,10%为女性。与通气相关的肺炎主要发生在住院时间超过 15 天且接受气管内插管的患者中(17%)。VAP 与合并症之间存在统计学显著差异,例如慢性阻塞性肺疾病、糖尿病、酒精中毒、肥胖、多器官创伤、出血/失血性休克以及骨折作为 ICU 患者入院的原因。患有慢性阻塞性肺疾病、肥胖、糖尿病和酒精中毒等合并症的患者是 VAP 的高危人群。对于因多器官创伤、骨折和出血/失血性休克而入院的患者,应特别注意易患 VAP 的患者。需要进一步研究不可变的 VAP 危险因素,例如合并症和 ICU 入院的原因,以便能够对这些患者进行更密切的 VAP 监测。