Measures for the prevention of pneumonia associated with mechanical ventilation in neurological patients
| Autor: | Ribas, EL Paiva, CA Rosa, CV Siva, M Pesavento, AM Cavalheiro, DF Moura, MC Guimenez |
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| Rok vydání: | 2009 |
| Předmět: |
Mechanical ventilation
medicine.medical_specialty education.field_of_study business.industry Urinary system Incidence (epidemiology) medicine.medical_treatment Cough reflex Population Critical Care and Intensive Care Medicine medicine.disease respiratory tract diseases Pneumonia Poster Presentation Emergency medicine Cuff medicine Breathing Intensive care medicine education business |
| Zdroj: | Critical Care |
| ISSN: | 1364-8535 |
| Popis: | Pneumonia associated with ventilation (VAP) develops after 48 hours of orotracheal intubation (OTI) and mechanical ventilation (MV). It develops because of the imbalance between the patient's defense mechanisms and the microbial agent. The patient using OTI loses the natural barrier, eliminating the cough reflex and promoting the accumulation of secretions above the cuff, and therefore could facilitate colonization and the aspiration of contaminated secretions. The incidence of VAP is high, varying between 6% and 52%, depending on the studied population, on the type of UTI and on the type of diagnosis technique used; therefore, in spite of being an extremely important infection, it is one of the most difficult diagnoses in critically ill patients. When compared with other nosocomial infections, such as the one of the urinary tract and skin, where the mortality is between 1% and 4%, VAP becomes an important mortality predictor, since this varies between 24% and 50%, and could be more than 70% when caused by multiresistant microorganisms. Patients seriously ill with diagnoses of trauma – it reviles cerebral, vascular accident – are of particularly larger risk for VAP, the incidence estimated to be between 40 and 50%. Programs of basic education have been recognizing that the occurrence of VAP can be reduced in 50% or more using several interventions to prevent the colonization and the aspiration of secretions as well as gastric content. The increasing frequency of resistant microorganisms represents a serious health problem. The ICU is a great source of resistant micro-organisms. Therefore, prevention should be part of the strategies of handling VAP. The mortality of this pathology can be reduced by the identification of the risk factors and of the prevention. |
| Databáze: | OpenAIRE |
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