medigraphic.com
ISSN 1405-0315 (Print)

2011, Number 3

<< Back Next >>

Rev Mex Enf Cardiol 2011; 19 (3)

Incidence of ventilator-associated pneumonia in patients related circuit change

Santiago AC, Cabrera PMF, Salazar CMC, Leija HC

Language: Spanish
References: 8
Page: 94-98
PDF size: 66.66 Kb.


ABSTRACT

The ventilator-associated pneumonia (VAP) prevention is due to is high morbidity and mortality; the risk factors are clearly identified and there are well established recommendations intended to diminish it. Nonetheless, there has not been a consensus on the mechanical ventilator circuits (MVC) management and on the time that they must be changed. With the results obtained in this investigation it is aimed to standardized the MVC frequency change, having as priority the quality and safety in the patients’ attention. Objective: Establish the relation between VAP incidence and MVC frequency change. Methodology: A retrospective, co relational and longitudinal study with an intervention consisting of modifying MVC frequency change, from every 48 hours to every 7 days, during the period between 2005 and 2009. The deliberate sample was constituted of 188 patients with mechanical ventilation who suffered from VAP after 48 hours. The study variables were: VAP incidence and MVC frequency change. The analysis was carried with SPSS version 17.0 with Spearman correlations, frequencies and percentages, considering significant p ‹ 0.05. Results: The MVC change was performed after 48 hours in 95 cases (50.5%) and after 7 days in 93 cases (49.5%). VAP incidence with MVC change every 48 hours was between 2 and 4.3%; with change every 7 days was between 2 and 1%, without being statistically significant (rs = 0.093, p = 0.103). Conclusion: The results allowed confirming that the time without MVC change has no direct effect on VAP incidence. It also allowed identifying the risk factors that could be analyzed to improve the practice and diminish VAP incidence in this group of patients; as such the MVC can be changed every 7 days.


REFERENCES

  1. Díaz E, Planas K, Rello J. Infecciones asociadas a los dispositivos utilizados para la ventilación asistida. Revista Enfermedades Infecciosas y Microbiología Clínica 2008; 26(7): 465-70.

  2. Maravi PE, Martínez SJM, Izurra J, Gutiérrez A, Tihista JA. Vigilancia y control de la neumonía asociada a ventilación mecánica. Anales Sis San [serie en internet] 2000 [citado 2009 octubre 20]; 23(2): 143-160. Disponible en: http://www.cfnavarra.es/salud/anales/textos/vol23/suple2/suple13a.html

  3. Norma Oficial Mexicana NOM-026-SSA2-1998, para la vigilancia epidemiológica, prevención y control de las infecciones. [Página en Internet]. México: Compendio de Normas Oficiales; 2003 [actualizado 21 julio 2003; citado 18 julio 2011]. Disponible en: http://www.facmed.unam.mx/sss/nom/normas%20oficiales.htm

  4. Resar R, Pronovost P, Haraden C, Simmonds T, Rainey T, Nolan T. Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia. Joint Commission Journal on Quality and Patient Safety [serie en internet] 2005 [citado 2009 octubre 20]; 31(5): 243-48. Available in: http://www.safetyleaders.org/Safe_Practice_Articles_NQF2006/Using_a_bundle_approach_to_improve_ventilator_care_processes_and_reduce_ventilator-associated_pneumonia_19_Resar_JCJQPS_05-05.pdf

  5. Dodek P, Keenan S, Cook D, Heyland D, Jacka M, Hand L et al. Canadian Critical Care Trials Group; Canadian Critical Care Society. Evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia. Ann Intern Med 2004; 141(4): 305-13.

  6. Torres A, Ramírez P. Factores de riesgo para la neumonía nosocomial adquirida en las Unidades de Cuidados Intensivos: ¿hay algo nuevo? Med Clin 2007; 128(20): 775-6.

  7. Soberanes RL, Molinar RF, Baltazar TJA, Gordillo BLH. Neumonía asociada a ventilación mecánica: comparación entre cambios de circuito del ventilador cada 72 horas versus cada 24 horas. Revista de la Asociación Mexicana de Medicina Crítica y Terapia Intensiva 1998; 12(6): 205-10.

  8. Guardiola J, Sarmiento X, Rello J. Neumonía asociada a ventilación mecánica: riesgos, problemas y nuevos conceptos. Medicina Interna [serie en Internet] 2001 [citado 2009 octubre 20]; 25(3): [aprox.11p]. Disponible en: http://www.elsevier.es/sites/default/files/elsevier/pdf/64/64v25n03a13013567pdf001.pdf




2020     |     www.medigraphic.com