Status quo investigation and risk prediction of ventilator-associated pneumonia in premature infants with extremely low birth weight
Objective To investigate the status quo of ventilator-associated pneumonia(VAP)in premature infants with extremely low birth weight,and to establish a risk prediction model.Methods The clinical data of 224 premature infants with extremely low birth weight who received mechanical ventilation(MV)in Nanyang Central Hospital from January 2019 to December 2022 were retro-spectively collected,and the incidence of VAP was calculated.Risk factors for VAP in premature infants with extremely low birth weight were analyzed by a logistic regression model,and a nomograph model for prediction of risks was established based on the above risk factors.The consistency index,calibration curve,and the receiver operating characteristic(ROC)curve were used to evaluate the prediction efficiency of the model.Results The incidence rate of VAP in 224 premature infants with extremely low body weight was 24.55%.A total of 60 strains were isolated from the bacterial culture of trachea secretion of children with VAP,including 42 strains(70.00%)of Gram negative bacteria,13 strains(21.67%)of Gram positive bacteria,and 5 strains(8.33%)of fungi.Logistic regression analysis results showed that anemia,lying flat,intubation times≥2,increased daily tracheal suction frequency,prolonged MV time,and maternal hypertension during pregnancy were independent risk factors for VAP in premature infants with extremely low birth weight(P<0.05),while the intravenous gamma globulin was a protective factor(P<0.05).The consistency index of the nomograph model for predicting VAP risk in premature infants with extremely low birth weight established based on the above factors was 0.81,the cali-bration curve fit well with the ideal curve,and the area under the ROC curve was 0.82,95%CI:(0.76,0.88).The decision curve of the no-mograph predicting VAP in extremely low birth weight premature infants had a high net benefit value in the range of 8%to 82%.Con-clusions Premature infants with extremely low birth weight have a high incidence rate of VAP,and anemia,lying flat,times of intuba-tion,frequency of daily endotracheal suction,MV time,and maternal hypertension during pregnancy are all independent influencing factors for VAP in them,and intravenous gamma globulin is a protective factor.The nomograph model established based on above fac-tors has a good predictive effect on the VAP risk in them.
万方数据
维普
