Thursday, 4 October 2018

Nursing Education 2019 Conference : Workshop

ICU, acquired pneumonia and ventilator: Is Ventilaor-associated Pneumonia an Independent Risk Factor for Death? By Fatma Slem, RN, New Mwasat Hospital, Kuwait 
  
Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs 48-72 hours or thereafter following endotracheal intubation, characterized by the presence of a new or progressive infiltrate, signs of systemic infection (fever, altered white blood cell count), changes in sputum characteristics, and detection of a causative agent. VAP contributes to approximately half of all cases of hospital-acquired pneumonia. VAP is estimated to occur in 9-27 % of all mechanically ventilated patients, with the highest risk being early during hospitalization. It is the second most common nosocomial infection in the intensive care unit (ICU) and the most common in mechanically ventilated patients. VAP rates range from 1.2 to 8.5 per 1,000 ventilator days and are reliant on the definition used for diagnosis. Risk for VAP is greatest during the first 5 days of mechanical ventilation (3 %) with the mean duration between intubation and development of VAP being 3.3 days. This risk declines to 2 %/day between days 5 to 10 of ventilation, and 1 %/day thereafter. Earlier studies placed the attributable mortality for VAP at between 33-50 %, but this rate is variable and relies heavily on the underlying medical illness. Over the years, the attributable risk of death has decreased and is more recently estimated at 9-13 % largely because of implementation of preventive strategies. Approximately 50 % of all antibiotics administered in ICUs are for treatment of VAP. Early onset VAP is defined as pneumonia that occurs within 4 days and this is usually attributed to antibiotic sensitive pathogens whereas late onset VAP is more likely caused by multidrug resistant (MDR) bacteria and emerges after 4 days of intubation. Thus, VAP poses grave implications in endotracheally intubated adult patients in ICUs worldwide and leads to increased adverse outcomes and healthcare costs.


3 comments:

Warun said...

education of the nursing is ensured and enhanced with the help of the individuals. All the issues of the education and go to page for the approval of the theories. The nurse is vital part of the medical field for the proper treatment of the patients.

Daniel said...

education of the nursing is produced for the efforts by the ladies. the rate of the illustration and read here for the punctuation of the information. It has even marked for the judgment and its impact for the future times.

Dani said...

nursing and education of the same is given for the completion of the goals. The challenge and useful link is advanced for the future times. The enhancement is don for the nursing above all the goals for the participants of the field.

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