Rangelova Vanya, Kevorkyan Ani, Raycheva Ralitsa, Krasteva Maya
Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.
Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.
Diagnostics (Basel). 2024 Jan 23;14(3):240. doi: 10.3390/diagnostics14030240.
The second most prevalent healthcare-associated infection in neonatal intensive care units (NICUs) is ventilator-associated pneumonia (VAP). This review aims to update the knowledge regarding the incidence of neonatal VAP and to summarize possible strategies for prevention. The VAP incidence ranges from 1.4 to 7 episodes per 1000 ventilator days in developed countries and from 16.1 to 89 episodes per 1000 ventilator days in developing countries. This nosocomial infection is linked to higher rates of illness, death, and longer hospital stays, which imposes a substantial financial burden on both the healthcare system and families. Due to the complex nature of the pathophysiology of VAP, various approaches for its prevention in the neonatal intensive care unit have been suggested. There are two main categories of preventative measures: those that attempt to reduce infections in general (such as decontamination and hand hygiene) and those that target VAP in particular (such as VAP care bundles, head of bed elevation, and early extubation). Some of the interventions, including practicing good hand hygiene and feeding regimens, are easy to implement and have a significant impact. One of the measures that seems very promising and encompasses a lot of the preventive measures for VAP are the bundles. Some preventive measures still need to be studied.
新生儿重症监护病房（NICU）中第二常见的医疗保健相关感染是呼吸机相关性肺炎（VAP）。本综述旨在更新有关新生儿VAP发病率的知识，并总结可能的预防策略。在发达国家，VAP发病率为每1000个呼吸机日1.4至7例，在发展中国家为每1000个呼吸机日16.1至89例。这种医院感染与更高的疾病发生率、死亡率以及更长的住院时间相关，给医疗系统和家庭都带来了沉重的经济负担。由于VAP病理生理学的复杂性，已经提出了多种在新生儿重症监护病房预防VAP的方法。预防措施主要有两大类：一类是试图总体上减少感染的措施（如消毒和手部卫生），另一类是专门针对VAP的措施（如VAP护理集束、床头抬高和早期拔管）。其中一些干预措施，包括保持良好的手部卫生和喂养方案，易于实施且效果显著。集束措施似乎非常有前景，涵盖了许多VAP预防措施。一些预防措施仍有待研究。
