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Objective@#To analyze the high risk factors and prognosis of patients with ventilator associated pneumonia(VAP) treated with mechanical ventilation(MV) in Intensive Care Unit(ICU), and to provide theoretical evidence for effective treatment and prevention.@*Methods@#From January 2015 to January 2017, 156 MV patients treated in ICU of Shaoxing Municipal Hospital were enrolled retrospectively.According to the occurrence of VAP, the patients were divided into VAP group(76 cases) and non-VAP group(80 cases). The data including sex, age, ICU time, MV time, cases of withdrawing machine failure, prognosis, serum albumin, blood glucose levels, APACHE Ⅱ score, types of antibiotics and days of continuous applying were recorded.Single factor χ2 test and multiple factor logistic regression analysis were used to analyze the high-risk factors and prognosis related to occurrence of VAP.@*Results@#Univariate analysis showed that the age, mortality, serum albumin and blood glucose levels, MV time, weaning failure rate, APACHE Ⅱ score, antibiotic combination type and days of continuous use, application of H2 receptor antagonists time between, the VAP group and non-VAP group had statistically significant differences (χ2=6.568, 16.558, 5.132, 5.896, 27.043, 15.018, 48.863, 46.752, 27.431, 3.981, P=0.010, 0.000, 0.023, 0.015, 0.000, 0.000, 0.000, 0.000, 0.000, 0.046). After age adjustment, logistic regression analysis showed that serum albumin <30g/L, blood glucose ≥7.8mmol/L, MV time >5 days, APACHE Ⅱ score>15 points, antibiotics continuous use>3 days, and antibiotic combination type>2 were independent risk factors for VAP(χ2=5.115, 5.984, 21.252, 18.043, 9.008, 14.545, P=0.030, 0.026, 0.000, 0.000, 0.007, 0.001). Compared with surviving patients with VAP, death patients lived longer in ICU and MV, and APACHE Ⅱ scores were higher(t=4.136, 6.382, 7.312, P=0.000, 0.000, 0.000).@*Conclusion@#There are multiple high-risk factors of VAP in patients treated with MV in ICU.The death demonstrated longer ICU time, MV time and higher APACHE Ⅱ score, need to be strengthened monitoring, early prevention and treatment.
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Objective To analyze the high risk factors and prognosis of patients with ventilator associated pneumonia(VAP) treated with mechanical ventilation(MV) in Intensive Care Unit(ICU),and to provide theoretical evidence for effective treatment and prevention. Methods From January 2015 to January 2017,156 MV patients treated in ICU of Shaoxing Municipal Hospital were enrolled retrospectively.According to the occurrence of VAP,the patients were divided into VAP group(76 cases) and non-VAP group(80 cases).The data including sex,age,ICU time,MV time, cases of withdrawing machine failure, prognosis, serum albumin, blood glucose levels, APACHE Ⅱscore,types of antibiotics and days of continuous applying were recorded. Single factor χ2 test and multiple factor logistic regression analysis were used to analyze the high-risk factors and prognosis related to occurrence of VAP. Results Univariate analysis showed that the age, mortality, serum albumin and blood glucose levels, MV time, weaning failure rate,APACHE Ⅱ score,antibiotic combination type and days of continuous use,application of H2 receptor antagonists time between,the VAP group and non-VAP group had statistically significant differences (χ2 =6.568,16.558,5.132,5.896,27.043,15.018,48.863,46.752,27.431,3.981,P=0.010,0.000,0.023,0.015, 0.000,0.000,0.000,0.000,0.000,0.046). After age adjustment,logistic regression analysis showed that serum albumin <30g/L, blood glucose ≥7. 8mmol/L, MV time >5 days, APACHE Ⅱ score >15 points, antibiotics continuous use>3 days, and antibiotic combination type >2 were independent risk factors for VAP ( χ2 =5.115, 5.984,21.252,18.043,9.008,14.545,P=0.030,0.026,0.000,0.000,0.007,0.001).Compared with surviving patients with VAP, death patients lived longer in ICU and MV, and APACHE Ⅱ scores were higher ( t =4.136, 6.382,7.312,P=0.000,0.000,0.000).Conclusion There are multiple high-risk factors of VAP in patients treated with MV in ICU.The death demonstrated longer ICU time,MV time and higher APACHEⅡscore,need to be strengthened monitoring,early prevention and treatment.
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Objective To observe and analyze the clinical effect of dexmedetomidine combined with sufentanil in the treatment of ICU mechanical ventilation. Methods 80 cases of critically ill patients treated by mechanical ventilation in our hospital ICU from February 2014 to March 2015 were randomly divided into study group and control group (n=40), the study group was treated with dexmedetomidine and sufentanil combined drug treatment, the control group was treated with sufentanil and midazolam combined drug treatment. The sedative effect and analgesic effect of the two groups were compared at different time points after the administration. Results At each time point after medication, there was no significant difference with the score of SAS between study group and control group; The BPS scores of respiratory compliance, upper limb and facial expression of the study group were lower than those of the control group, the difference was statistically significant; the incidence of adverse reaction in the study group was 7.5% (3/40), which was significantly lower than that of the control group 22.5% (9/40), the difference was statistically significant (P<0.05); There were no significant differences in MAP, SpO2 and HR between the two groups before treatment; After treatment, the indexes of MAP, SpO2 and HR in the two groups at different time points and after extubation were significantly different from those before treatment (P<0.05), The difference of MAP, SpO2 and HR between the two groups at each time point after treatment and after extubation were statistically significant (P<0.05). Conclusion The combination of dexmedetomidine and sufentanil for ICU mechanical ventilation has a good sedative and analgesic effect, and is worthy of clinical practice, and it is worthy of clinical practice.