Al Mouwasat Hospital, Al-Khobar, Saudi Arabia.
School of Nursing, clinical nursing, The University of Jordan, Amman, Jordan.
Nurs Manag (Harrow). 2022 Feb 3;29(1):32-40. doi: 10.7748/nm.2021.e1986. Epub 2021 Oct 26.
Ventilator-associated pneumonia is the most frequent infection seen in intensive care units. Of those patients with an endotracheal tube, many will develop ventilator-associated pneumonia within 48 hours of being mechanically ventilated. There are many issues related to mechanical ventilation including costs, patient outcomes and the amount of suffering patients experience during the process.
To determine the relationship between development of ventilator-associated pneumonia and patient outcomes and costs, including length of stay on mechanical ventilation, in intensive care units (ICU) and in hospital, and mortality rates and to compare results between ventilator-associated pneumonia and non-ventilator-associated pneumonia groups.
Cross-sectional, observational design. A convenience sample of 151 patients on mechanical ventilation (101 with ventilator-associated pneumonia and 50 with non-ventilator-associated pneumonia) were recruited from ICUs in two public hospitals in Jordan. APACHE-II scores, SOFA scores and clinical pulmonary infection scores (CPIS) were assessed.
The incidence rate of ventilator-associated pneumonia was 50.9/1000 mechanical ventilation days and the cumulative incidence rate was 66.9% among patients on mechanical ventilation. The mean score of hospital length of stay and CPIS was significantly higher in the ventilator-associated pneumonia than the non-ventilator-associated pneumonia group. Higher disease severity and higher organ failure scores increase the risk of mortality in patients with ventilator-associated pneumonia.
A high ventilator-associated pneumonia incidence rate is associated with increased mechanical ventilation, ICU and hospital length of stays, higher mortality and attributed costs. There is a need for continuing education and training for ICU staff to reduce ventilator-associated pneumonia incidence in ICUs.
呼吸机相关性肺炎是重症监护病房最常见的感染。在那些有气管插管的患者中，许多患者在机械通气后 48 小时内会发生呼吸机相关性肺炎。机械通气涉及许多问题，包括成本、患者结局以及患者在这一过程中所经历的痛苦程度。
确定呼吸机相关性肺炎的发生与患者结局和成本（包括机械通气时间、重症监护病房和医院住院时间、死亡率）之间的关系，并比较呼吸机相关性肺炎组和非呼吸机相关性肺炎组的结果。
采用横断面观察性设计。从约旦两家公立医院的重症监护病房中招募了 151 名机械通气患者（101 名患有呼吸机相关性肺炎，50 名患有非呼吸机相关性肺炎），采用便利抽样法。评估了急性生理学和慢性健康评估 II 评分（APACHE-II 评分）、序贯器官衰竭评估评分（SOFA 评分）和临床肺部感染评分（CPIS）。
呼吸机相关性肺炎的发生率为 50.9/1000 机械通气日，机械通气患者的累积发生率为 66.9%。呼吸机相关性肺炎组的平均住院时间和 CPIS 评分显著高于非呼吸机相关性肺炎组。疾病严重程度和器官衰竭评分越高，呼吸机相关性肺炎患者的死亡率风险越高。
高呼吸机相关性肺炎发生率与机械通气时间、重症监护病房和医院住院时间延长、死亡率升高和相关成本增加有关。需要对重症监护病房的工作人员进行持续的教育和培训，以降低重症监护病房中呼吸机相关性肺炎的发生率。
