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Objective@#To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China.@*Method@#A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis.@*Result@#A total of 7 918 patients were enrolled, within whom 4 623(58.4%) were males. The birth weight was (1 639±415) g and the gestational age was (31.4±2.0) weeks; 4 654(58.8%) infants required non-invasive mechanical ventilation and 2 154(27.2%) required intubation. Of all the mechanically ventilated patients, VAP occurred in 95 patients. The overall VAP rate was 7.0 episodes per 1 000 ventilator days, varying from 0 to 34.4 episodes per 1 000 ventilator days in different centers. The incidence of VAP was 9.6 and 6.0 per 1 000 ventilator days in children′s hospitals and maternity-infant hospitals respectively, without significant differences (t=1.002, P=0.327). Gram-negative bacilli (76 strains, 91.6%) were the primary VAP microorganisms, mainly Acinetobacter baumannii (24 strains, 28.9%), Klebsiella pneumonia (23 strains, 27.7%), and Pseudomonas aeruginosa (10 strains, 12.0%).@*Conclusion@#The incidence of VAP in China is similar to that in developed counties, with substantial variability in different NICU settings. More efforts are needed to monitor and evaluate the preventable factors associated with VAP and conduct interventions that could effectively reduce the occurrence of VAP.
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Background: Different additives have been used to prolong brachial plexus block. We performed a prospective, randomized single-blind study to compare Bupivacaine alone and Bupivacaine along with Buprenorphine for onset, quality, and duration of block as well as post-operative analgesia and any complication in axillary brachial- plexus block. Methods: Randomized controlled study was carried out among 60 patients of either sex, aged 20-60 years. ASA grade I or II undergoing elective hand, forearm, elbow surgery under axillary brachial plexus block. Patients were randomly divided into two groups. Group-l received 30 ml of 0.35% Bupivacaine alone in axillary block. Group-II received 30 ml of 0.35% Bupivacaine with 3µg/kg Buprenorphine in axillary block. Time taken for onset and completion of motor and sensory block as well as complete duration of block were noted in both groups. Any complication during procedure, during surgery as well as post-operatively were noted and treated. Results: Addition of Buprenorphine (3µg/kg) to Bupivacaine mixture in peripheral nerve block did not affected the onset time for motor as well as sensory block. Mean duration of motor block was 284.33±78.94 mins. in group I and in group II 307.33±60.26 mins. Mean duration of sensory block 305.066±83.64 mins. in group I while 580.166±111.45 mins. in group II. It suggests duration of sensory block was prolonged in group II then group I. Conclusions: Addition of Buprenorphine to local anesthetic drug provides good post-operative analgesia. Buprenorphine significantly prolongs sensory block and lengthens duration of analgesia without prolonging duration of motor block.