Department of Pulmonary and Critical Care Medicine, Xuanwu Hospital Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 10053, China.
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China International Neuroscience Institute (China-INI), No. 45 Changchun Street, Xicheng District, Beijing, 10053, China.
BMC Infect Dis. 2022 Jan 20;22(1):66. doi: 10.1186/s12879-022-07053-7.
Ventilator-associated pneumonia (VAP) is a severe infection among patients in the neurosurgery intensive care unit (NICU).
We retrospectively evaluated risk factors for early-onset ventilator-associated pneumonia (EOVAP) from January 2019 to December 2019 at a NICU. A total of 89 NICU patients who were intubated within 48 h of onset and whose mechanical ventilation time was at least 7 days were enrolled. We evaluated EOVAP that occurred within the first 7 days after the onset of mechanical ventilation. The enrolled patients had no history of chronic lung disease and no clinical manifestations of infection before intubation. Clinical data of patients were recorded, and the incidence of and risk factors for EOVAP were analyzed. Patients were also grouped by age (≥ 65 vs. < 65 years) and whether they had received hypothermia treatment or not.
Among 89 mechanically ventilated patients (49 men and 40 women; the mean age ± SD was 60.1 ± 14.3 years), 40 patients (44.9%) developed EOVAP within 7 days and 14 patients (15.7%) had a multidrug resistant bacterial infection. Binary logistic regression analysis indicated that older age (≥ 65 years) (odds ratio [OR]:3.53, 95% confidence interval [CI]:1.27-9.79, P = 0.015) and therapeutic hypothermia (OR:3.68, CI:1.10-12.31, p = 0.034) were independent predictors of EOVAP. Levels of peripheral blood leukocytes, neutrophils and platelets were lower in the therapeutic hypothermia group than those who did not receive hypothermia treatment.
This study found that older age (≥ 65 years) and therapeutic hypothermia were independently associated with the risk of EOVAP in NICU patients.
呼吸机相关性肺炎（VAP）是神经外科重症监护病房（NICU）患者中一种严重的感染。
我们回顾性评估了 2019 年 1 月至 2019 年 12 月期间 NICU 中早发性呼吸机相关性肺炎（EOVAP）的危险因素。共纳入 89 例机械通气 48 小时内发病且机械通气时间至少 7 天的 NICU 患者。我们评估了机械通气开始后 7 天内发生的 EOVAP。纳入患者无慢性肺部疾病史，插管前无感染临床表现。记录患者的临床资料，分析 EOVAP 的发生率及危险因素。并根据年龄（≥ 65 岁与＜65 岁）和是否接受低温治疗进行分组。
在 89 例机械通气患者（男 49 例，女 40 例；平均年龄±标准差为 60.1±14.3 岁）中，40 例（44.9%）在 7 天内发生 EOVAP，14 例（15.7%）发生多重耐药菌感染。二项逻辑回归分析表明，年龄较大（≥ 65 岁）（比值比[OR]：3.53，95%置信区间[CI]：1.27-9.79，P=0.015）和治疗性低温（OR：3.68，CI：1.10-12.31，P=0.034）是 EOVAP 的独立预测因素。治疗性低温组外周血白细胞、中性粒细胞和血小板水平低于未接受低温治疗者。
本研究发现，年龄较大（≥ 65 岁）和治疗性低温与 NICU 患者 EOVAP 的风险独立相关。
