Among the hospital-acquired infections, ventilator-associated pneumonia (VAP) has the highest mortality and morbidity rates. The aim of this study was to identify VAP in the intensive care unit (ICU) and its association with the severity of the disease. This descriptive-analytic study was conducted in Golestan University of Medical Sciences (Northern Iran). In the present study, 239 patients undergoing mechanical ventilation hospitalized in ICU were selected through non-random sampling. Data were recorded by using APACHE II criteria and diagnosis of VAP was made based on clinical criterion and physician confirmation. Data were analyzed by independent t-test, Chi-square test, Mann-Whitney test, and single-variable logistic test. The incidence of VAP was 19.2% and it was significantly related to mean arterial pressure (P = 0.035) and male sex (P = 0.122). There was a significant and direct correlation between the incidence of VAP and the increase in the value of gastric residual volume > 200 ml (P = 0.001). The findings of this study showed that male sex, increased arterial pressure, and gastric residual volume were the risk factors for the development of of VAP.
References
1.
Hashemian M, Talaie H, Akbarpour S, Mahdavinejad A, Mozafari N. Central Nervous System Depressants Poisoning and Ventilator Associated Pneumonia: An Underrated Risk Factor at the Toxicological Intensive Care Unit. Iranian Red Crescent Medical Journal. 18(1).
2.
Liu W, Jiao Y, Xing H, Hai Y, Li H, Zhang K, et al. Active surveillance of ventilator-associated pneumonia in the intensive care unit and establishment of the risk grading system and effect evaluation. Annals of Translational Medicine. 2019;7(22):617–617.
3.
Faramarzi E, Mahmoodpoor A, Hamishehkar H, Shadvar K, Iranpour A, Sabzevari T, et al. Effect of gastric residual volume monitoring on incidence of ventilator-associated pneumonia in mechanically ventilated patients admitted to intensive care unit. Pakistan Journal of Medical Sciences. 36(2).
4.
Ozen N, Tosun N, Yamanel L, Altintas ND, Kilciler G, Ozen V. Evaluation of the effect on patient parameters of not monitoring gastric residual volume in intensive care patients on a mechanical ventilator receiving enteral feeding: A randomized clinical trial. Journal of Critical Care. 2016;33:137–44.
5.
Wu D, Wu C, Zhang S, Zhong Y. Risk Factors of Ventilator-Associated Pneumonia in Critically III Patients. Frontiers in Pharmacology. 10.
6.
Rebmann T, Greene LR. Preventing catheter-associated urinary tract infections: An executive summary of the Association for Professionals in Infection Control and Epidemiology, Inc, Elimination Guide. American Journal of Infection Control. 2010;38(8):644–6.
7.
Abdelrazik Othman A, Salah Abdelazim M. Ventilator-associated pneumonia in adult intensive care unit prevalence and complications. The Egyptian Journal of Critical Care Medicine. 2017;5(2):61–3.
8.
Nobahar M, R RM, F M. Incidence of ventilator-associated pneumonia in intensive care units and its relationship with risk factors. RJMS. 2016;22(139):134–45.
9.
Liang J, Li Z, Dong H, Xu C. Prognostic factors associated with mortality in mechanically ventilated patients in the intensive care unit. Medicine. 98(42):e17592.
10.
Ranjbar H, Jafari S, F K. Effect of Chlorhexidine gluconate oral rinse on preventing of late onset ventilator associated pneumonia and it’s interaction with severity of illness. Iranian J Crit Care Nurs (IJCCN. 2010;3(2):81–6.
11.
Chao YC, Chen Y, Wang KK, Lee R, Tsai H. Removal of oral secretion prior to position change can reduce the incidence of ventilator‐associated pneumonia for adult ICU patients: a clinical controlled trial study. Journal of Clinical Nursing. 2009;18(1):22–8.
12.
Hedrick TL, Smith RL, McElearney ST, Evans HL, Smith PW, Pruett TL, et al. Differences in Early- and Late-Onset Ventilator-Associated Pneumonia Between Surgical and Trauma Patients in a Combined Surgical or Trauma Intensive Care Unit. Journal of Trauma: Injury, Infection & Critical Care. 2008;64(3):714–20.
13.
Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Medicine. 2020;46(5):888–906.
14.
Chang L, Dong Y, Zhou P. Investigation on Risk Factors of Ventilator-Associated Pneumonia in Acute Cerebral Hemorrhage Patients in Intensive Care Unit. Canadian Respiratory Journal. 2017;2017:1–4.
15.
Kózka M, Sega A, Wojnar-Gruszka K, Tarnawska A, Gniadek A. Risk Factors of Pneumonia Associated with Mechanical Ventilation. International Journal of Environmental Research and Public Health. 17(2):656.
16.
Nora D, Póvoa P. Antibiotic consumption and ventilator-associated pneumonia rates, some parallelism but some discrepancies. Annals of Translational Medicine. 2017;450–450.
17.
Afkhamzadeh A, Lahoorpour F, A D. Incidence of ventilator-associated pneumonia (VAP) and bacterial resistance pattern in adult patients hospitalised at the intensive care unit of Besat Hospital in Sanandaj. Sci J Kurdistan University Med Sci. 2011;16(1):20–6.
18.
Nassaji M, Mosavi S, Ghorbani R. Incidences of nosocomial pneumonia in patients above 15 years in intensive care units of university hospital in Semnan. Koomesh. 2004;5(1):89–94.
19.
Mathai AS, Phillips A, Kaur P, Isaac R. Incidence and attributable costs of ventilator-associated pneumonia (VAP) in a tertiary-level intensive care unit (ICU) in northern India. Journal of Infection and Public Health. 2015;8(2):127–35.
20.
Millot G, Voisin B, Loiez C, Wallet F, Nseir S. The next generation of rapid point-of-care testing identification tools for ventilator-associated pneumonia. Annals of Translational Medicine. 2017;451–451.
21.
Jaffal K, Six S, Zerimech F, Nseir S. Relationship between hyperoxemia and ventilator associated pneumonia. Annals of Translational Medicine. 2017;453–453.
22.
Saini V, Gandhi K, Kaur K, Yaddanapudi LN. Effect of intensive education and training of nurses on ventilator-associated pneumonia and central line-associated bloodstream infection incidence in intensive care unit at a tertiary care center in North India. Indian Journal of Critical Care Medicine. 2017;21(11):779–82.
23.
Hurley J. Unusually High Incidences of Staphylococcus aureus Infection within Studies of Ventilator Associated Pneumonia Prevention Using Topical Antibiotics: Benchmarking the Evidence Base. Microorganisms. 6(1):2.
24.
Awad L, Abdallah D, Mugharbil A, Jisr T, Droubi N, El Rajab N, et al. An antibiotic stewardship exercise in the ICU: building a treatment algorithm for the management of ventilator-associated pneumonia based on local epidemiology and the 2016 Infectious Diseases Society of America/American Thoracic Society guidelines. Infection and Drug Resistance. Volume 11:17–28.
25.
Ju MH, Yao YL, Du CL, Chen S, Song YL. Subsequent Multidrug-Resistant Bacteremia Is a Risk Factor for Short-Term Mortality of Patients with Ventilator-Associated Pneumonia Caused by Acinetobacter baumannii in Intensive Care Unit. Chinese Medical Journal. 2018;131(3):361–3.
26.
Haque M, Sartelli M, McKimm J, Abu Bakar MB. Health care-associated infections – an overview. Infection and Drug Resistance. Volume 11:2321–33.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.