Neumonía intrahospitalaria asociada a ventilación mecánica en un hospital del estado de Tabasco, México

Abstract

Objective: To evaluate the cases of nosocomial pneumonia in patients with mechanical ventilation (NAVM), from the regional hospital of high specialty Gustavo Adolfo Rovirosa Pérez in the emergency area, from January 2016 to December 2017. Methods: A quantitative, observational, retrospective and transversal study was carried out. The variables of interest were taken from critical patients admitted to the emergency department, with mechanical ventilation requirements that developed pneumonia 48 hours after the start of ventilatory support. 97 clinical files were reviewed, 30 met the inclusion criteria, a format for the collection and elaboration of the database was elaborated, for the analysis of the variables, the statistical software Spss version 22 was used. Results: The distribution of VAP by gender was higher in men (62.9%) than in women (37.1%) and the ages ranged between 18 and 86 years. The main cause of admission diagnoses was severe TBI (71.4%), followed by cranial-facial trauma (20%) and moderate TBI with poor secretion management (8.6%). Of the total of analyzed files, 35 corresponded to NAVM, with an average evolution of 2 to 5 days and up to more than 20 days. 88.6% presented fever and all patients with leukocytosis with a minimum value of 15,000. On chest radiographs, infiltrates and condensation zones were observed in 48.6% of the cases; in the case of the affected hemithorax, the most frequent was the right (62.9%), followed by bilateral (22.9%) and left (14.3%) injuries. Conclusions: The development of VAP, is related to the time of exposure to orointubation. Clinical signs and radiographic changes are related to the suspicion of this type of pneumonia and practically in all cases, they presented admission diagnoses related to some type of trauma.