[Reducing the incidence of ventilator-associated pneumonia following heart surgery: 13-year experience of epidemiologic surveillance in a teaching hospital].

Autor:	Ajenjo MC; Departamento de Medicina Interna, Hospital Clínico Pontificia Universidad Católica de Chile, Santiago, Chile. majenjo@puc.cl, Zambrano A, Eugenin MI, Achurra P, Zalaquett R, Irarrázaval MJ, De la Cerda G, Fernández P, Barañao M, Fuentealba P, Ferrés M, García P, Pérez C, Labarca J
Jazyk:	Spanish; Castilian
Zdroj:	Revista chilena de infectologia : organo oficial de la Sociedad Chilena de Infectologia [Rev Chilena Infectol] 2013 Apr; Vol. 30 (2), pp. 129-34.
DOI:	10.4067/S0716-10182013000200002
Abstrakt:	Objectives: To report the results of 13 years worth of epidemiologic surveillance of ventilator-associated pneumonia (VAP) following heart surgery and the main interventions applied in order to reduce VAP incidence. Methods: This is a retrospective and descriptive study of active epidemiologic surveillance of VAP. National diagnostic criteria were used. Interventions associated with a decrease in VAlP incidence in adults who underwent heart surgery are described. Results: A significant and sustained reduction was observed in the rate of VAP; being 56.7 per 1,000 ventilator-days in 1998 vs 4.7 per 1,000 ventilator-days in 2010 (p < 0.001). The strongest reduction was observed following 2003 (34.4 to 14.8 per 1,000 ventilator-days in 2004, p < 0.001). The interventions with greatest impact were the implementation of an early-weaning protocol, the introduction of trained nurses to perform the mechanical ventilator equipment management and the routine use of alcohol-based hand rubs. Conclusion: Epidemiologic surveillance associated with the establishment of a multifactorial intervention program applied in collaboration with the attending team, have demonstrated a significant reduction of VAP incidence after heart surgery.
Databáze:	MEDLINE
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