The effect of probiotic on reducing ventilator-associated pneumonia incidence in sepsis patients with mechanical ventilation / 中华急诊医学杂志

Objective:To explore the effect of probiotics on reducing ventilator-associated pneumonia (VAP) in sepsis patients.Methods:A total of 94 cases were randomly (random number) divided into the probiotic group ( n = 46) and the control group ( n = 48). All of the patients were given enteral nutrition therapy by nasogastric tube within 24-72 h after admission. And patients in the probiotic group were given live combined bifidobacterium, lactobacillus and enterococcus powder besides the regular therapy. The incidence of VAP, bacteremia, mortality, mechanical ventilation time and length of ICU stay were compared between the two groups. Results:Compared with the control group, the incidences of VAP and bacteremia in the probiotics group were significantly lower (χ 2=4.763, P=0.029; χ 2=4.438, P=0.035). There were no significant differences in 28-day mortality and the length of hospital stay between the two groups (χ 2=2.02, P=0.167; t=1.29, P=0.208). Mechanical ventilation time in the probiotics group was significantly shorter than that in the control group ( t=2.16, P=0.038). The Log-Rank test showed that the time of VAP-free in the probiotics group was significantly longer than that in the control group ( P < 0.05). After adjusting for APACHEⅡ score and age, COX proportional risk model analysis showed that the RR values of the probiotics group and the control group for 28-day VAP were 0.18 (95% CI: 0.12-0.74, P=0.025) and 0.21 (95% CI: 0.19-0.95, P=0.042), respectively. Conclusions:Probiotics treatment can reduce the incidence of VAP in sepsis patients.

Effect of different types of endotracheal tubes on ventilator-associated pneumonia / 中华急诊医学杂志

Objective To compare the clinical effect of conventional polyvinyl chloride (PVC) endotracheal tube with silicone wire reinforced endotracheal tube to prevent ventilator-associated pneumonia (VAP) in mechanical ventilation patients.Methods A total of 240 mechanical ventilation patients in the ICU were enrolled in this study,which were divided into two groups,PVC endotracheal intubation group (PVC group,n=1 13) and wire reinforced endotracheal intubation group (WR group,n=127).Gender,age,APACHE Ⅱ score,one-time success rate of intubation,intubation time,the rate of changing endotracheal,ventilation time,rate of tracheotomy and the incidence of VAP were compare between the two groups.Predictive factors for VAP were identified by the univariate and multivariate analyses in step-wise logistic regression model.Results The rate of changing endotracheal tube in the PVC group was lower than that in the WR group (x2=5.785,P=0.016);the mechanical ventilation time in the PVC group was shorter than that in the WR group (t=2.180,P=0.018);and compared with the WR group,the PVC group had significantly lower incidence of VAP (x2=6.215,P=0.012).The univariate analysis showed that the selection ofPVC endotracheal tube,APACHE Ⅱ score and mechanical ventilation time were the significant risk factors for VAP (P ＜ 0.05).Multivariate analysis showed that the different selection of endotracheal tube and mechanical ventilation time were independent influencing factors ofVAP (P ＜ 0.05).Conclusions PVC tracheal tube can effectively reduce the incidence of VAP in patients with mechanical ventilation.

Effect of different types of endotracheal tubes on ventilator-associated pneumonia / 中华急诊医学杂志

Objective@#To compare the clinical effect of conventional polyvinyl chloride (PVC) endotracheal tube with silicone wire reinforced endotracheal tube to prevent ventilator-associated pneumonia (VAP) in mechanical ventilation patients.@*Methods@#A total of 240 mechanical ventilation patients in the ICU were enrolled in this study, which were divided into two groups, PVC endotracheal intubation group (PVC group, n=113) and wire reinforced endotracheal intubation group (WR group, n=127). Gender, age, APACHEⅡ score, one-time success rate of intubation, intubation time, the rate of changing endotracheal, ventilation time, rate of tracheotomy and the incidence of VAP were compare between the two groups. Predictive factors for VAP were identified by the univariate and multivariate analyses in step-wise logistic regression model.@*Results@#The rate of changing endotracheal tube in the PVC group was lower than that in the WR group (χ2=5.785, P=0.016); the mechanical ventilation time in the PVC group was shorter than that in the WR group (t=2.180, P=0.018); and compared with the WR group, the PVC group had significantly lower incidence of VAP (χ2=6.215, P=0.012). The univariate analysis showed that the selection of PVC endotracheal tube, APACHE Ⅱ score and mechanical ventilation time were the significant risk factors for VAP (P < 0.05). Multivariate analysis showed that the different selection of endotracheal tube and mechanical ventilation time were independent influencing factors of VAP (P < 0.05).@*Conclusions@#PVC tracheal tube can effectively reduce the incidence of VAP in patients with mechanical ventilation.