Prevention Of Pulmonary Infection Research Articles

Chinese expert consensus on diagnosis, treatment and prevention of pulmonary infection in patients with solid tumors (2024 edition)

Patients with solid tumors have an increased risk of developing pneumonia during the management of tumor. The prevention, diagnosis, and treatment of pneumonia in these patients have different characteristics compared to the general population, such as the correction of specific risk factors for pneumonia and the rational use of prophylactic antimicrobial drugs, the strategy of invasive sampling diagnostic techniques application, differential diagnosis from anti-tumor treatment associated pulmonary conditions, and consideration of pathogens and drug resistance in empirical antimicrobial treatment. In order to standardize the diagnosis, treatment, and prevention of pneumonia in patients with solid tumors, Oncology Respiratory Disease Committee initiated the "Chinese expert consensus on the diagnosis and treatment of pneumonia in patients with solid tumors". Based on a review of the latest evidence in this field, the consensus provides diagnostic and treatment pathways as well as recommendations. This consensus applies to oncologists, pulmonologists, infectious disease physicians, surgeons, emergency medicine physician, and general practice healthcare professionals involved in the management of solid tumors in adults.

Vaccination to Prevent Pseudomonas aeruginosa Bloodstream Infections.

The bacterium Pseudomonas aeruginosa (Pa) is ubiquitous in the environment and causes opportunistic infections in humans. Pa is increasingly becoming one of the most difficult to treat microorganisms due to its intrinsic and acquired resistance to multiple antibiotics. The World Health Organization estimates that at least 700,000 people die each year from drug resistant microbial infections and have listed Pa as one of three bacterial species for which there is the most critical need for the development of novel therapeutics. Pa is a common cause of bloodstream infections (BSI) and bacterial sepsis. With nearly 49 million sepsis cases and 11 million deaths worldwide, an effective vaccine against Pa could prevent the morbidity and mortality resulting from Pa BSI and lessen our dependence on antibiotics. We reviewed the current landscape of Pa vaccines in pre-clinical and clinical stages over the last two decades. It is readily apparent that Pa vaccine development efforts have been largely directed at the prevention of pulmonary infections, likely due to Pa’s devastating impact on individuals with cystic fibrosis. However, the increase in nosocomial infections, BSI-related sepsis, and the emergence of widespread antibiotic resistance have converged as a major threat to global public health. In this perspective, we draw attention to potential Pa vaccine candidates and encourage a renewed effort for prophylactic vaccine development to prevent drug-resistant Pa BSI.

Clinical effect of individualized nursing program on prevention of pulmonary infection in elderly patients with hypertension complicated with intracerebral hemorrhage.

article: Clinical effect of individualized nursing program on prevention of pulmonary infection in elderly patients with hypertension complicated with intracerebral hemorrhage - Minerva Medica 2021 Feb 08 - Minerva Medica - Journals

Traditional Chinese Medicine nursing in prevention of pulmonary infection in patients with hypertensive cerebral hemorrhage

Traditional Chinese Medicine nursing in prevention of pulmonary infection in patients with hypertensive cerebral hemorrhage

Pulmonary infections complicating ARDS.

Pulmonary infection is one of the main complications occurring in patients suffering from acute respiratory distress syndrome (ARDS). Besides traditional risk factors, dysregulation of lung immune defenses and microbiota may play an important role in ARDS patients. Prone positioning does not seem to be associated with a higher risk of pulmonary infection. Although bacteria associated with ventilator-associated pneumonia (VAP) in ARDS patients are similar to those in patients without ARDS, atypical pathogens (Aspergillus, herpes simplex virus and cytomegalovirus) may also be responsible for infection in ARDS patients. Diagnosing pulmonary infection in ARDS patients is challenging, and requires a combination of clinical, biological and microbiological criteria. The role of modern tools (e.g., molecular methods, metagenomic sequencing, etc.) remains to be evaluated in this setting. One of the challenges of antimicrobial treatment is antibiotics diffusion into the lungs. Although targeted delivery of antibiotics using nebulization may be interesting, their place in ARDS patients remains to be explored. The use of extracorporeal membrane oxygenation in the most severe patients is associated with a high rate of infection and raises several challenges, diagnostic issues and pharmacokinetics/pharmacodynamics changes being at the top. Prevention of pulmonary infection is a key issue in ARDS patients, but there is no specific measure for these high-risk patients. Reinforcing preventive measures using bundles seems to be the best option.

Respiratory tract management in a case of spinal muscular atrophy with neuromuscular scoliosis

Objective To summarize the experience of respiratory tract management in a case of spinal muscular atrophy with neuromuscular scoliosis. Methods Respiratory tract nursing included prevention of pulmonary infection, inspiratory muscle training, rebuilding respiratory form before surgery, and assessment of sputum expectoration capacity, pain management, airway management after surgery. Results The patient was discharged without pulmonary complications. Conclusions For patient with breathing problem, respiratory tract management can prevent pulmonary complications during perioperative period. Key words: Spinal muscular atrophy; Neuromuscular scoliosis; Inspiratory muscle training

Gastrostomy Placement and Management in Children: A Single-Center Experience.

BACKGROUND: To prevent malnutrition and food aspiration in children with chronic neuromuscular problems, enteral nutrition provided by gastrostomy is recommended. Long-term follow-up data about surgical and medical complications of PEG are available, but few papers have addressed all of the issues in the same series. METHODS: This retrospective study enrolled patients under 18 years who had a gastrostomy tube placed at our institution between 2003 and 2017. The aim is to evaluate outcomes after gastrostomy placement, focusing both on surgical complications (early and late), and its effect on their nutritional status, on the prevention of pulmonary infections, and their parents’ opinion. RESULTS: Eighty-four gastrostomies were placed in total (35 F; 49 M). Seventy-seven patients had a severe neurocognitive impairment (GMFCS 5). The principal indication for gastrostomy was severe dysphagia (53.3%). No gastrostomy-related death was observed. Early surgical complications were observed in five of 84 (5,9%) patients; late complications were observed in 15 of 84 (17.8%) patients. Twenty-two patients were diagnosed with subsequent gastroesophageal reflux; five patients developed dumping syndrome (6%). Complete medical follow-up data were available for 45 patients. A progressive improvement of nutritional status was observed in 29 patients, and 11 maintained the same percentile; the occurrence of respiratory infections and need for hospitalization decreased. In 90% of cases, parents were fully satisfied with the g-tube. CONCLUSION: This study confirms the positive nutritional outcomes of gastrostomy-tube with an associated small risk of surgical complications and a reduction in the number of respiratory infections, with most parents scoring their experience as positive.

Predicting risk of pulmonary infection in patients with primary membranous nephropathy on immunosuppressive therapy: The AIM-7C score.

Pulmonary infection (PI) is the leading cause of death in patients with primary membranous nephropathy on immunosuppressive therapy. A rating score was thus developed to foresee the risk of PI in such patients. We reviewed the charts of the pertinent patients treated during the past 3 years either with (n = 29) or without PI (n = 304). Clinical and laboratory data, the usage of cyclosporin A (CysA), and occurrence of PI were recorded. Cox regression analysis and receiver operating characteristic (ROC) curve were respectively used to identify the risk factors and assess their clinical relevance. The incidence of PI was 8.7% at 82.1 ± 20.9 days after the initiation of CysA regimen with a male predominance superimposed on smoking. Factors associated with PI were immunoglobulin G titer (hazard ratio = 4.56, 95% confidence interval = 2.31-8.95), plasma CysA concentration (3.71, 1.87-6.18), serum creatinine level (2.57, 1.31-5.82), CD4+ /CD8+ ratio (2.36, 1.26-6.06) and plasma albumin content (1.53, 1.05-3.25). These five factors, along with the male gender and smoking status, were granted different ratings after examined by the ROC curve and constituted the anticipating pulmonary infection in primary membranous nephropathy receiving CysA (AIM-7C) score. Accordingly, the respective percent composition of the infection and non-infection group was 0, 11.1%, 72.2%, 16.7% and 91.7%, 8.3%, 0, 0 in the order of low, moderate, high and utmost risk. Furthermore, eight new cases of PI were successfully predicted. Our AIM-7C score may therefore help to predict the onset and facilitate the prevention of PI, a potentially life-threatening complication of the immunosuppressive therapy.

Application of multidisciplinary team model on prevention of perioperative pulmonary infection among elderly patients

Objective To explore the effects of multidisciplinary team (MDT) model on prevention of perioperative pulmonary infection among elderly patients. Methods From August 2017 to May 2018, we selected 162 elderly patients with surgery in Department of Gastrointestinal Surgery at Renji Hospital affiliated to School of Medicine, Shanghai Jiaotong University. All of the patients were divided into groups according to hospitalization order. A total of 88 patients from August to December 2017 were in control group, and 74 patients from January to May 2018 were in intervention group. Control group provided routine nursing. On the basis of routine nursing, intervention group carried out the MDT intervention model. We compared the incidence of perioperative pulmonary infection and hospital stay of patients between two groups. Results The incidence of perioperative pulmonary infection of intervention group (4.1%) was lower than that (13.6%) of control group with a statistical difference (P<0.05) . The hospital stay of patients of intervention group (8.502±2.542) days was less than that (9.342±2.343) days of control group also with a statistical difference (P<0.05) . Conclusions MDT intervention can reduce the perioperative pulmonary infection among elderly patients and shorten the average hospital stay of patients. Key words: Aged; Perioperative nursing; Pulmonary infection; Preventive medicine; Multidisciplinary team

Respiratory morbidity in children with cerebral palsy: an overview

Respiratory problems have a significant impact on morbidity and mortality in patients with cerebral palsy (CP). In particular, recurrent aspiration, impaired airway clearance, spinal and thoracic deformity, impaired lung function, poor nutritional status, and recurrent respiratory infections negatively affect respiratory status. Bronchopulmonary dysplasia may contribute to pulmonary problems, but asthma is not more common in CP than in the general population. We discuss treatment options for each of these factors. Multiple coexisting and interacting factors that influence the respiratory status of patients with CP should be recognized and effectively addressed to reduce respiratory morbidity and mortality. WHAT THIS PAPER ADDS: Respiratory problems are a significant cause of morbidity in patients with cerebral palsy (CP). Respiratory status in patients with CP is influenced by recurrent aspiration and impaired airway clearance. Spinal and thoracic deformity, impaired lung function, poor nutrition, and respiratory infections also negatively affect respiratory status. These factors should all be addressed to reduce respiratory problems in patients with CP.

Analysis of the effect of comprehensive nursing intervention on pulmonary infection in patients with severe neurosurgery

Objective: Investigated the effect of comprehensive nursing intervention on the prevention of pulmonary infection in severe patients in department of neurosurgery. Methods: Randomly divided 89 patients with neurosurgical intensive cases admitted in our hospital from April 2014 to September 2016 into two groups, 43 patients in the control group underwent routine neurosurgical care, and 46 cases in the observation group underwent comprehensive nursing intervention. Compared the Barthel index score, tracheotomy time, the length of ICU stay and hospital stay between the two groups before and after nursing care, and observed the lung infection and satisfaction. Results: There was no significant difference in daily living ability and Barthel index score between the two groups (P>0.05), which were significantly improved after treatment. And the observation group was significantly higher than that of the control group, the difference between the two groups was statistically significant (P<0.05), the incidence of lung infection, aspiration, expectoration and hypoxemia in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). In addition, the overall satisfaction of the observation group was 95.65%, which was higher than that of the control group (79.07%), and the difference was significant (P<0.05). Conclusion: Comprehensive nursing intervention on the prevention of pulmonary infection in severe patients in department of neurosurgery can not only promote the recovery of patients, but also can effectively prevent complications such as lung infection, improve living ability.

The effect of body position management in different periods on the prevention of pulmonary infection of elderly patients with hip fracture

Objective To explore the effect of body position management in different periods on the prevention of pulmonary infection of elderly patients with hip fracture. Methods A total of 60 cases of elderly hip fracture patients with surgical treatment in our hospital from September 2013 to March 2015 were selected as the control group.The control group was given routine nursing measures, while a total of 60 cases of elderly hip fracture patients with surgical treatment in our hospital from April 2015 to September 2016 were selected as the observation group.The observation group were given the corresponding body position management at different periods on the basis of regular nursing.The incidence of pulmonary infection of the patients of the two groups during the perioperative period were compared and analyzed. Results The CPIS score, pulmonary infection rate and satisfaction score, rehabilitation knowledge measurement of the observation group was significantly better than that of the control group, and the difference was statistically significant (P<0.05). During the hospital stay, the postoperative fever duration, infection recovery time of the observation group was significantly less than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Effective body position management for the elderly patients with hip fracture can reduce the incidence of pulmonary infection after operation, shorten the days of hospital stay, reduce the pain of patients, reduce the hospital mortality due to pulmonary infection, and effectively improve the overall level of nursing in the department of orthopedics, it is worth being popularized in clinical application. Key words: Body position management; The elderly; Hip fracture; Pulmonary infection; Prevention

Clinical analysis on nosocomial pulmonary infection in patients with indwelling tracheal tube

Tracheal intubation by tracheotomy or by placing a tracheal tube through larynx into trachea, is not only one of important measures which are taken to rescue critically ill patients with respiratory failure etc., but a commonly used method to prevent patients from airway obstruction in the postoperative period and facilitate mechanical ventilation. Meanwhile, the incidence rate of pulmonary infection, a complication caused by indwelling tracheal tubes, especially the incidence rate of hospital acquired pulmonary infection is apparently increasing. Particularly, pulmonary infection of this kind has characteristics of easily recurrent seizures, long treatment period and high drug-resistance. Hence, it is required for medical personnel to summarize, analyze and study not only general nursing, airway nursing and prevention of pulmonary infection, but also antibiotic selection as well as how and when to use those drugs after the incidence of pulmonary infection for the benefit of patients with indwelling tracheal tube. This article is based on a case collected from Comprehensive Surgery Department of the Third Affiliated Hospital of Inner Mongolia Medical University. The patient’s history is as follows: 1. Pulmonary infection; 2. Indwelling tracheal catheter after tracheotomy; 3. Carbon monoxide toxic cerebrosis, mute state. By means of this case analysis, it is expected to make an early detection, and give an early and proper treatment to patients with pulmonary infection caused by indwelling tracheal tubes in clinical practice.

Nursing of elderly patients with severe brain injury after tracheotomy

Objective To discuss and summarize nursing measures of elderly patients with severe brain injury after tracheotomy. Methods A retrospective analysis was carried out in 60 elderly patients with severe traumatic brain injury after tracheotomy in our hospital from July, 2009 to August, 2010, all patients were given holistic nursing care, including close observation of patients' condition, controlling the suction time, methods and techniques, strict aseptic technique, to effectively prevent infection. Results In the implementation of the patient-centered holistic care, the results were significant, 49 cases survived the acute phase and finally removed tracheal tube. Only 5 patients had pulmonary infection, accounting for 8.3%. 3 patients died due to brain injury and 5 cases were discharged against advice, 3 patients did not gain extubation due to severe brain stem injury. Conclusions The patients with severe head injury need tracheotomy to maintain airway patency, timely call-back, suction, effective airway humidification, prevention of pulmonary infection, reduction of respiratory tract injury is key to successful treatment. The patientcentered holistic care is worthy of wide clinical application. Key words: Severe brain injury; Tracheotomy; Care