Analysis of risk factors related to ventilator-associated tracheobronchitis / 中华全科医师杂志

ABSTRACT

A total of 178 patients with the time of mechanical ventilation beyond 48 hours in the second affiliated hospital of Wenzhou medical college from January 2010 to December 2013 were enrolled in this study,and there were fifty-six patients with ventilator-associated tracheobronchitis (VAT).The associated factors included age,sex,blood pressure,blood glucose,BMI,the time of mechanical ventilation,tracheal intubation methods,raise head to 30-45°,proton pump inhibitors (PPI),prophylactic antibiotic treatment,glasgow coma scale (GCS),acute physiology and chronic health evaluation (APECHE) Ⅱ score.The related factors of VAT were evaluated by using univariate logistical regression analysis,and the statistical significant variables were analyzed by using multivariate logistical regression analysis.By using univariate logistical regression analysis age,blood glucose,the time of mechanical ventilation,raise head to 30-45°,prophylactic antibiotic treatment,GCS and APECHE Ⅱ score were the important factors of VAT (P ＜ 0.05),but sex,blood pressure,BMI,tracheal intubation methods and PPI were insignificant related to VAT(P ＞ 0.05).By using multivariate logistical regression analysis the time of mechanical ventilation (OR =4.072,95％ CI 2.036-8.146),GCS[2.198(1.155-4.184)],age[2.128 (1.119-4.046)],APECHE Ⅱ score [2.109 (1.084-4.104)] and raise head to 30-45 ° [0.488 (0.243-0.979)] were associated independently with the VAT.The time of mechanical ventilation,GCS,age over 60 years,APECHE Ⅱ score and raise head to 30-45°were the independent factors associated with VAT.