呼吸机支持使用的持续时间和呼吸机相关性肺炎的发展:何时是最危险的时间?

R. Alfaray, Muhammad Mahfud, Rafiqy Sa’adiy Faizun
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引用次数: 2

摘要

简介:呼吸机相关性肺炎(VAP)是在机械通气超过48小时的患者中发生的肺炎。使用呼吸机的持续时间被确定为触发VAP的危险因素。目的:本研究旨在确定巨港Dr. Mohammad Hoesin总医院重症监护室患者呼吸机使用时间与VAP发生率之间的关系。方法和材料:本研究为观察性分析研究,采用横断面设计。样本为2014年7月1日至2015年6月30日在ICU病房使用呼吸机超过48小时的患者。从患者病历中获得的数据共146例,但符合标准的患者数量为106例。结果与讨论:106例患者中,41例(38.7%)发生VAP, 65例(61.3%)未发生VAP。卡方检验分析显示,与使用呼吸机2-5天的患者相比,使用呼吸机>5天的患者OR = 3.273 (p值= 0.016;95% CI = 1.223 ~ 8.754)。结论:巨港Dr. Mohammad Hoesin综合医院ICU患者呼吸机使用时间与VAP发生率之间存在显著相关性。使用呼吸机5天以上的患者发生VAP的风险是使用呼吸机2-5天的患者的3386倍。患者使用呼吸机的最危险时间为使用5天以上。41例VAP患者的死亡率为63.4%,而全ICU患者的死亡率为50.9%。
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Duration Of Ventilation Support Usage And Development Of Ventilator-Associated Pneumonia: When Is The Most Time At Risk?
Introduction: Ventilator-Associated pneumonia (VAP) is pneumonia that occurs in patients who have been mechanically ventilated for a duration of more than 48 hours. The duration of ventilator use was identified as a risk factor which is a trigger of VAP. Objective: This study aimed to determine the association between the duration of ventilator use and the incidence of VAP in patients in the Intensive Care Unit of Dr. Mohammad Hoesin General Hospital, Palembang. Method and Material: This study was an observational analytic study using a cross-sectional design. The samples were all patients who use a ventilator for more than 48 hours at the ICU room period of July 1, 2014, to June 30, 2015. Data were obtained from the patient’s medical records of a total of 146 patients, but the number of patients who comply with the criteria was 106 patients. Result and Discussion: Out of the 106 samples, 41 patients (38.7%) developed VAP and 65 patients (61.3%) did not develop VAP. The analysis using Chi-Square test showed that patients who used ventilator for >5 days had an OR = 3.273 compared to patients using ventilator 2-5 days (p-value = 0.016; 95% CI = 1.223 to 8.754). Conclusion: There is a significant association between the duration of ventilator use and the incidence of VAP in patients at the ICU of Dr. Mohammad Hoesin General Hospital, Palembang. Patients using ventilators for more than 5 days 3,386 times more at risk of developing VAP compared to patients using ventilators 2-5 days. The riskiest time for the patient using ventilator was more than 5 days of usage. And, the mortality rate of VAP patients was 63.4% from 41 patients while the mortality rate of whole ICU patients was 50.9%.
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