KẾT QUẢ ĐIỀU TRỊ VIÊM PHỔI LIÊN QUAN THỞ MÁY TẠI KHOA CẤP CỨU VÀ HỒI SỨC TÍCH CỰC BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Objective: To evaluate the treatment results of ventilator-associated pneumonia (VAP) in the Emergency and Intensive Care Department of Hanoi Medical University Hospital during 2022–2024. Methods: This was a descriptive study. All patients aged over 18 years who received mechanical ventilation for more than 48 hours at the Emergency and Intensive Care Department of Hanoi Medical University Hospital between April 1, 2022, and April 31, 2024, were included. Results: A total of 127 patients underwent invasive mechanical ventilation, of whom 68 developed ventilator-associated pneumonia (VAP), accounting for 53.5%, with an incidence rate of 44.8 per 1,000 ventilator days. Clinically, most patients had a Glasgow Coma Scale score of 13–15 (66.2%); leukocytosis (>10 G/L) was observed in 55.9%, and procalcitonin levels >2 ng/mL in 41.2%. The main causative pathogens were Acinetobacter baumannii (36.8%), Klebsiella pneumoniae (29.4%), and Pseudomonas aeruginosa (14.7%). The mean duration of mechanical ventilation among VAP patients was 12.49 ± 6.47 days (range 5–31), and the mean ICU length of stay was 17.04 ± 9.03 days (range 5–43). The 30-day mortality rate following VAP diagnosis was 35.3%. Conclusion: VAP remains a frequent and serious complication in mechanically ventilated patients in the ICU. Multidrug-resistant Gram-negative bacteria, particularly A. baumannii and K. pneumoniae, were the leading pathogens. Patients with VAP required significantly longer durations of mechanical ventilation and ICU stay, and the 30-day mortality rate remained high at 35.3%.