Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain.
Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain.
J Perinatol. 2021 Jun;41(6):1467-1473. doi: 10.1038/s41372-021-01086-7. Epub 2021 May 25.
We hypothesized that the implementation of evidence-based interventions shaping a bundle approach could significantly reduce the incidence of ventilator-associated pneumonia (VAP) in the neonatal intensive care unit.
We conducted a prospective observational cohort study including neonates undergoing mechanical ventilation >48 h. VAP rate and endotracheal intubation ratio were compared before (pre-period) and after (post-period) applying VAP prevention bundle strategies.
One hundred seventy-four neonates were included in pre-period (30 months) and 106 in post-period (17 months). Demographic characteristics were comparable and device use ratios were similar. Twenty-eight VAP episodes were diagnosed, 25 in the first period and 3 after the implementation of prevention bundle. This represents a reduction in the incidence rate from 11.79 to 1.93 episodes/1000 ventilator days (p < 0.01).
The implementation of an educational evidence-based program using a bundle approach to prevent VAP has shown a statistically significant reduction in its incidence density.
我们假设实施以证据为基础的干预措施形成的一整套方案，可以显著降低新生儿重症监护病房（NICU）呼吸机相关性肺炎（VAP）的发生率。
我们进行了一项前瞻性观察性队列研究，纳入了机械通气时间超过 48 小时的新生儿。比较了应用 VAP 预防捆绑策略前后（预阶段和后阶段）的 VAP 发生率和气管内插管比例。
174 例新生儿纳入预阶段（30 个月），106 例纳入后阶段（17 个月）。人口统计学特征相似，器械使用比例也相似。诊断出 28 例 VAP 病例，第 1 阶段 25 例，第 1 阶段后 3 例。这表示发病率从每 1000 通气日 11.79 例降至 1.93 例（p<0.01）。
采用捆绑式方法实施基于证据的教育方案预防 VAP 已显示其发病率密度有统计学显著降低。
