VENTILATOR ACQUIRED PNEUMONIA

Ventilator Acquired Pneumonia

Ventilator Acquired Pneumonia

Introduction

Many years ago, the pneumonia was called 'the old man in another, "as many people suffering from chronic diseases, ultimately died from it. This is not true, because of modern technology in medicine for the prevention and treatment of pneumonia. According to the observations from the National Nosocomial Infection Surveillance (NNIS) system of the Centers for Disease Control and Prevention (CDC), pneumonia is the second most common nosocomial infections in general. Patients undergoing mechanical ventilation are at risk of ventilator-associated pneumonia (VAP). And what happens after that date is considered late at the start of pneumonia (Wenzel 2003 56-60). Nosocomial pneumonia is the leading cause of death from hospital acquired diseases associated with crude mortality rates by about 30 per cent.

Discussion

Patients receive continuous, mechanical ventilation support are from 6 to 21 times the risk for acquiring nosocomial pneumonia compared with patients not receiving ventilatory support. The risk for developing ventilator-associated pneumonia increases by 1% per day. Thus, ventilator dependent resident is likely to develop pneumonia within 3 months is given to the fan.

This increased risk is due in part to the carriage of oropharyngeal organisms after the passage of endotracheal tubes during intubation tracheal or insertions, as well as in depressed host defense secondary character in relation to patients with underlying serious illness. Early onset ventilator-associated pneumonia are most often due to bacteria sensitive to antibiotics (eg, oxacillin of Staphylococcus Aureus, Haemophilus influenzae and Streptococcus pneumoniae), while the late start of ventilator-associated pneumonia is often caused by antibiotic-resistant pathogens.

The distribution of organisms varies from one hospital to another, but Gram-negative bacillus and S. Aureus is the predominant pathogen. Nosocomial legionellosis is endemic in some hospitals due to contaminated water. Polymicrobial infections were common and no microbial agent can be identified in about half the cases (D'Amico 2008 1275-1285). Nosocomial pneumonia can also be the result of the impact of infectious aerosols in the environment in a hospital from contaminated respiratory therapy equipment, Legionella in water, or Aspergillus disputes in a ventilation system.

For many years, VAP was diagnosed on clinical criteria published by (Silvestri 2004 185-190), which included the emergence of new or progressive pulmonary infiltrate, fever, leukocytosis, and purulent allocation tracheobronchial (Johanson WG Jr., Pierce AK, Sanford JP, Thomas D.. 1972), but these criteria are nonspecific (Pugin 2001 1121-9). In mechanically ventilated patients, fever may be caused by a drug reaction, extrapulmonary infection, blood transfusion, or extrapulmonary inflammation. Pulmonary infiltrates may be associated with pulmonary hemorrhage, chemical aspiration, pleural effusion, congestive heart failure, or tumor. And fever and pulmonary infiltrates occur in the late fibroproliferation acute respiratory distress syndrome, atelectasis, and pulmonary embolism, as well as the GSA. Cultures of tracheal aspirates are not very useful in establishing the cause of VAP (Meduri GU. 1993). Although such cultures are highly sensitive, their specificity is low, even when they are cultured quantitatively. VAP is the most accurate diagnosis of quantitative culture and microscopic examination of lower respiratory tract, secretions, which are best, obtained bronchoscopically directed ...