Risk factors and distribution of pathogenic bacteria of ventilator-associated infection complications
Objective To provide epidemiological data for the prevention and control of ventilator-asso-ciated event(VAE),and to provide a scientific basis for the formulation of measures to prevent and control VAE by studying the risk factors and pathogen distribution of ventilator-associated infection complications(IVAC),the second grade of VAE in intensive care unit(ICU).Methods A prospective cohort study was conducted on 684 adult patients who underwent invasive mechanical ventilation for 4 days or more during tra-cheal intubation or tracheotomy in the Intensive Care Unit of Xuzhou Medical University Affiliated Hospital and EICU from January 2023 to January 2024.Univariate and multivariate logistic regression models were used to screen for possible risk factors for IVAC.Results Among 684 patients,62 cases of ventilator-associat-ed events occurred,including 33 cases of IVAC,including 15 cases of simple IVAC and 18 cases of suspected pneumonia.The incidence of IVAC was 4.82％(33/684);The mortality rate was 30.30％(10/33)per thou-sand days of mechanical ventilation.IVAC patients were comatose from the establishment of artificial airway to the fourth day of mechanical ventilation,the average daily positive fluid balance was greater than or equal to 50 mL,the average daily gastric retention was greater than or equal to 200 mL,the bed head was not raised for more than or equal to 4 days,and the proportion of sedatives and muscle relaxants used from the fourth day of mechanical ventilation was significantly higher than that of non IVAC patients,with statistically significant differences(P＜0.05).From the establishment of artificial airway to the fourth day of mechanical ventilation,the average daily positive fluid balance is greater than or equal to 50 mL,the bed head is not raised for more than or equal to 4 days,and the average daily gastric retention is greater than or equal to 200 mL,which are in-dependent risk factors for IVAC,with statistically significant differences(relative risk=22.95,17.83,9.46).Conclusion The occurrence of IVAC is a comprehensive result of many factors.Effective bundles of Care should be taken to reduce IVAC and reduce the incidence of ventilator-associated complications.
万方数据
维普
