埃及大学儿童医院儿童呼吸机相关肺炎的危险因素:一项前瞻性研究

A. Noaman
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摘要

目的探讨儿童呼吸机相关性肺炎(VAP)发生的危险因素。背景与设计进行前瞻性观察性研究。该研究是在埃及曼苏拉大学儿童医院的儿科重症监护病房(PICU)进行的,为期1年。该研究包括154名患者。患者和方法对人口统计学特征等变量进行分析;既往住院和PICU入住;使用的药物,如肌力药物、类固醇、镇静剂、H2阻滞剂或质子泵抑制剂;营养疗法;慢性疾病;侵入性手术,如中央静脉导管插入;机械通气时间(MV);和PICU停留在VAP发展之前。所有患者在前24小时采用儿科死亡风险评分III进行评估,并通过日常临床检查、放射学和实验室评估评估VAP。结论在曼苏拉大学儿童医院重症监护室中,使用类固醇和镇静药、留置时间延长、PICU留置时间是导致VAP发生风险增加的主要危险因素。
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Risk factors of ventilator-associated pneumonia in children in an Egyptian University Children’s Hospital: a prospective study
Aim To evaluate the risk factors that contribute to the development of ventilator-associated pneumonia (VAP) in children. Settings and design A prospective observational study was conducted. The study was done in pediatric intensive care unit (PICU) at Mansoura University Children’s Hospital, Egypt, over 1 year. The study included 154 patients. Patients and methods Many variables were analyzed such as demographic characteristics; previous hospital and PICU admission; drugs used such as inotropes, steroids, sedatives, H2 blockers, or proton pump inhibitors; nutritional therapies; chronic illnesses; invasive procedures such as central line insertion; duration of mechanical ventilation (MV); and PICU stay before development of VAP. Statistical analysis used All patients were assessed by Pediatric Risk of Mortality Score III in the first 24 h and evaluated for VAP by daily clinical examination and by radiological and laboratory evaluation. Results Duration of MV and PICU stay (before development of VAP) markedly increased the incidence of VAP (P value for both was Conclusions Use of steroids and sedatives, prolonged MV, and length of PICU stay are the main risk factors that contribute toward the increased risk of VAP development in Mansoura University Children’s Hospital intensive care.
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