Abstract
A STUDY OF VENTILATOR ASSOCIATED PNEUMONIA: INCIDENCE AND OUTCOME

Goyal Sumit, Singh Lalit, Agrawal Anurag, Tandon Rajeev, Agrawal Nipun* and Nirala Pradeep

ABSTRACT

Background: Ventilator-associated pneumonia (VAP) is leading cause of death among hospital acquired infections. Nearly one-third of nosocomial pneumonia cases, VAP being most common, develop in the ICU. Its incidence varies from 13–51 per 1,000 ventilator days depending on hospital setting and patient group. Typically patients’ develop VAP within first week of mechanical ventilation. HAP and, most importantly, VAP increase duration of hospitalisation and healthcare costs. The nosocomial pneumonia mortality rate can reach up to 70%. There are multiple studies suggestive of 30-50% mortality due to VAP being consequence of infection and even higher when that infection is due to Pseudomonas aeruginosa and Acinetobacter spp. The present study was planned to study the incidence and outcome of VAP. Material and methods: This prospective study was conducted over a period of one and half year. 70 patients above 18 years of age of either sex subjected to new intubation at MICU of SRMSIMS and mechanical ventilation for more than 48 hours in Critical Care Facility not having Pneumonia prior to initiation of mechanical ventilation and not with known HIV seropositivity were considered for the study. A detailed history was taken and all cases were subjected to hemogram, hepatic and renal function tests, blood sugar, and chest X-ray (PA view). Chest radiograph was taken after 48 hours of mechanical ventilation. Endotracheal aspirate were taken from all the patients 48hrs after being mechanically ventilated and sent for culture and sensitivity to the Microbiology lab of SRMS IMS. The statistical analysis was done using IBM SPSS. The values were represented as Number (%). Appropriate statistical test were used where required. Result: Incidence of VAP was 14.3%. Commonest finding on X-Ray after development of VAP was bilateral pneumonia followed by unilateral pneumonia to the right side. Commonest organism isolated in the cultures of patients who developed VAP was Klebsiella pneumoniae followed by Acinetobacter baumanii. Out of 10 (14.3%) patients who developed VAP, 7 patients suffered mortality whereas 60 (85.7%) patients didn’t develop VAP, 17 patients from them suffered mortality.

Keywords: Ventilator associated pneumonia, VAP, ICU, Mechanical ventilation, Klebsiella pneumoniae, Acinetobacter baumanii.


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