ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ BỆNH NHÂN VIÊM PHỔI LIÊN QUAN THỞ MÁY TẠI KHOA HỒI SỨC TÍCH CỰC, BỆNH VIỆN HỮU NGHỊ ĐA KHOA NGHỆ AN

Abstract

Objective: to describe of clinical, laboratory and result of treatment of ventilation - acquired pneumoniae patient (VAP) at the Intensive Care Unit of Nghe An General Friendship Hospital. Subjects and methods: Cross - sectional descriptive study on 84 VAP patients treated at the Intensive Care Unit of Nghe An General Friendship Hospital from October 2022 to November 2023. Result: Rate of VAP was 9.2%, incidence was 20.3/1000 ventilated days. The largest age group was ≥ 60 years (66.7%). Majority was male with 71.4%. The most common disease on ICU admission was cerebral hemorrhage with a rate of 61.9%. The most common medical history was hypertension with a rate of 50% The most common indication for intubation was coma with a rate of 82.1%. Majority of patient in study had fever (70.2%), change in sputum properties (71.4%), leukocytosis (78.6%). The average VAP occurrence was 4.8±1.8 days, the average duration of ventilation was 7.3±2.2 days, the average duration in ICU stay was 9.3±2.4 days, the average duration of hospital stay was 11.9±5.9 days. The postitive bacterial culture was seen in 70.2% patients, more common in with the late VAP than that in early VAP (82.9% versus 61.2%), 15.5% patient had 2 types of bacteria in the same culture sample. Gram-negative bacteria are the most common with a rate of 80.6%. The most common bacteria that cause VAP was Klebsiella pneumoniae with a rate of 23.6%, next was Acinetobacter baumannii with a rate of 20.8%, Pseudomonas aeruginosa with a rate of 20.8%, Staphylococcus aureus with a rate of 18.1%. The most common type of bacteria that caused early VAP were Klebsiella pneumoniae and Staphylococcus aureus. The most common type of bacteria that caused late VAP were Pseudomonas aeruginosa and Acinetobacter baumannii. Treatment was better (transferred to another department, dischaged, referred to low level hospital): 59.5%, and worse (dead, home discharged, referred to higher level hospital): 40.5%.