NGUYÊN NHÂN GÂY VIÊM PHỔI LIÊN QUAN THỞ MÁY Ở TRẺ EM TẠI KHOA ĐIỀU TRỊ TÍCH CỰC NỘI KHOA, BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objectives: Ventilator associated pneumoniae (VAP) was  common in the intensive care unit. Microbiological diagnosis brought profound benefits but still in trouble. Fibre-bronchoscopy, an invasive intervention, showed numerous effectivenesses in diagnosis, treatments and prognosis in Pediatric intensive care units, including VAP diagnosis. The aims of this research to identify the cause of VAP and to compare the microbiological results of bronchoalveolar lavage fluids and tracheal aspiration cultures to diagnosis of VAP. Subjects and methods: descriptive study was conducted in the Intensive care unit in the National Children Hospital to following up 93 participants suspected VAP by CDC criteria. Results:  93 patiens included in the study. 63.4% of the participants were males, and 62% of them were under 12 months old. VAP diagnosis was based on a positive quantitative culture of bronchoalveolar lavage fluid (cutoff > or = 10⁴ CFU/mL). A final diagnosis of VAP was established in 44 patients and there was no infection in 49 cases. Cause of VAP: Pseudomonas and Acinetobacter were the most common causes, with 31% and 35%. The microbiological results of  tracheal aspiration and bronchoaveolar fluids were statistical difference. The specificity and sensitivity of tracheal aspiration culture were not high (86,6-41,7%). The culture of bronchoaveolar fluids showed high sensitivity and specificity. Conclusion: the rate of VAP due to Pseudomonas and Acinetobacter were the highest. The results of tracheal aspiration culture were not fully represent to the cause of VAP. it was beneficial in the use of microbiological culture of bronchoalveolar fluids to identify the cause of VAP in Pediatric intensive care unit.