Department of ICU, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei 441021, China.
J Healthc Eng. 2022 Feb 17;2022:9055587. doi: 10.1155/2022/9055587. eCollection 2022.
This study discussed and analyzed the risk factors and nursing countermeasures of ventilator-associated pneumonia (VAP) in the children intensive care unit (ICU).
In this study, 155 children with mechanical ventilation in the pediatric intensive care unit from Oct. 2018 to Oct. 2020 were chosen as research objects. We retrospectively analyzed the clinical data of children and divided them into VAP groups and non-VAP groups according to the occurrence of VAP. Subsequently, we adopted a univariate and multivariate logistic regression model to analyze and clarify the risk factors of VAP and formulated the corresponding nursing countermeasures.
49 cases of total research objects had occurred VAP, with an infection rate of 31.62%. The primary pathogenic bacteria were Gram-negative bacteria (43/70, 61.43%). According to multivariate logistic regression analysis, the duration of mechanical ventilation, invasive procedures, and application of hormones and antacids are all independent risk factors for VAP in pediatric ICU. The VPA group had longer hospital stay than the non-VAP group, and the difference was statistically significant ((20.92 ± 4.16)d, (15.24 ± 3.77)d, = 8.4383, ≤ 0.001). The hospitalization cost of the VPA group was substantially higher than that of the non-VAP Group ((45.8 ± 10.4) thousand Yuan, (33.2 ± 4.3) thousand Yuan, = 10.6822, ≤ 0.001).
Children admitted to the pediatric ICU have a high VAP incidence. The primary pathogenic bacteria are Gram-negative bacteria. As the occurrence of VAP is closely related to a variety of factors, we should take targeted nursing countermeasures to reduce the duration of mechanical ventilation and the frequency of invasive operations and use the hormone and antacids rationally to reduce the risk of VAP and improve the prognosis.
本研究探讨并分析了儿童重症监护病房(ICU)呼吸机相关性肺炎(VAP)的危险因素和护理对策。
本研究选择 2018 年 10 月至 2020 年 10 月在我院儿科重症监护病房接受机械通气的 155 例患儿为研究对象。回顾性分析患儿的临床资料,根据是否发生 VAP 将患儿分为 VAP 组和非 VAP 组。采用单因素和多因素 logistic 回归模型分析并明确 VAP 的危险因素,并制定相应的护理对策。
155 例研究对象中共有 49 例发生 VAP,感染率为 31.62%。主要病原菌为革兰阴性菌(43/70,61.43%)。多因素 logistic 回归分析显示,机械通气时间、有创操作、应用激素和抑酸剂是儿科 ICU 发生 VAP 的独立危险因素。VPA 组的住院时间长于非 VPA 组,差异有统计学意义((20.92±4.16)d、(15.24±3.77)d,=8.4383,≤0.001)。VPA 组的住院费用明显高于非 VPA 组((45.8±10.4)万元、(33.2±4.3)万元,=10.6822,≤0.001)。
入住儿科 ICU 的患儿 VAP 发生率较高,主要病原菌为革兰阴性菌。由于 VAP 的发生与多种因素密切相关,应采取有针对性的护理对策,缩短机械通气时间和有创操作频率,合理使用激素和抑酸剂,降低 VAP 风险,改善预后。