Abstract
Abstract Introduction: Ventilator-Associated Pneumonia (VAP) is a common complication found in the Intensive Care Unit (ICU) and is associated with increased mortality, length of hospital stay and mechanical ventilation (MV) time. Objective: To determine the incidence of VAP and its impact on the clinical course of the subject undergoing invasive MV in the ICU. Methods: This is a cohort study of hospitalized subjects in the general adult ICU of the State Hospital of Bauru / SP. The clinical information for the period of 19 months were collected. Stratification for the groups was based on the presence or absence of VAP, free_VAP and VAP, respectively. The Hotelling T² with 95% confidence, chi-square and the Mann-Whitney tests were executed using the "R" software and the results showed as mean ± standard deviation and absolute and relative distribution (p < 0.05). Results: The sample was of 322 subjects; the VAP group consisted of 73 (22.67%), 54.79% male, age: 62.31±16.96 years and the APACHE II: 29.98 ± 8.64. The VAP group had longer time of the MV and of the ICU compared to free VAP group; even in this group, the highest incidence of death in the ICU occurred between the 16th and 20th day of hospitalization. The free VAP group was older and 50% of the patients discharged from hospital. Conclusion: VAP and their interfaces still impact on the clinical evolution of the subjects mainly on the time factor of MV and ICU stay. The highest incidence of death in the ICU occurs in the first weeks.
Highlights
Introduction: Ventilator-Associated Pneumonia (VAP) is a common complication found in the Intensive Care Unit (ICU) and is associated with increased mortality, length of hospital stay and mechanical ventilation (MV) time
The evolution of mechanical ventilation (MV) in recent years has been fundamental to increase the survival of subjects with respiratory failure, but its use is accompanied by undesirable effects, such as hemodynamic instability, lung injury, and respiratory infections
These changes can lead to morbidities, increasing the time and cost of hospitalization and raising the mortality rate [1 – 3]. One of these effects is the Ventilator-Associated Pneumonia (VAP), defined as a nosocomial infection that develops after 48 - 72 hours after the endotracheal intubation and the institution of invasive MV [4]
Summary
Ventilator-Associated Pneumonia (VAP) is a common complication found in the Intensive Care Unit (ICU) and is associated with increased mortality, length of hospital stay and mechanical ventilation (MV) time. The evolution of mechanical ventilation (MV) in recent years has been fundamental to increase the survival of subjects with respiratory failure, but its use is accompanied by undesirable effects, such as hemodynamic instability, lung injury, and respiratory infections. These changes can lead to morbidities, increasing the time and cost of hospitalization and raising the mortality rate [1 – 3]. One of these effects is the Ventilator-Associated Pneumonia (VAP), defined as a nosocomial infection that develops after 48 - 72 hours after the endotracheal intubation and the institution of invasive MV [4]. The aspiration of pathogenic microorganisms of the oropharynx and gastric and the time of intubation increase
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