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Indian Journal of Clinical Anaesthesia


Ventilator associated pneumonia in a ICU of a tertiary care Hospital in India


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Author Details: Debaprasad Mohanty, Mahendra Kumar Nayak, Khageswar Raut, Sidharth Sraban Routray, Debasis Mishra

Volume : 3

Issue : 2

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 139

Article End Page : 143


Abstract

Ventilator Associated Pneumonia (VAP) refers to a type of pneumonia that occurs more than 48–72 hours after endotracheal intubation. Risk factors include prolonged mechanical ventilation, reintubation after extubation. Our aim was to find the incidence of VAP, total days of mechanical ventilation, days of ICU and hospital stay at our institution, proportion of various bacterial pathogens isolated from tracheal aspirate of patients with VAP and their antibiotic sensitivity pattern.
Material &Methods: A prospective cohort study was conducted on 100 patients who were admitted to medical intensive care unit of SCB Medical college and on ventilatory support for two or more days and were not suffering from pneumonia prior to putting them on ventilator. Endotracheal aspirates were obtained under strict aseptic precautions using a 22-inch Romson’s 12F suction catheter with a mucus extractor. Gram staining and biochemical tests for identification and antimicrobial susceptibility test were performed. The patients were classified into four groups named VAP, NON VAP, SURVIVORS and NON SURVIVORS. All the data collected were compiled and tabulated.
Observation: The incidence of VAP in this study was 30%. The association between genders (p value-0.372), age (p value-0.929) and VAP infection was not found to be significant. There was no significant correlation between the primary disease and development of VAP (p value =0.24). Most common organism isolated was P. aeruginosa, (9 isolates) followed by MRSA (7 isolates) and most of them were resistant to commonly used antibiotics.
Conclusion: VAP patients have higher mortality rate, longer duration of mechanical ventilation and duration of hospital stay than NON VAP patients. Early diagnosis of VAP and initiation of appropriate antibiotic treatment is vital to prevent the adverse outcomes.

Key Words: Ventilator, Pneumonia, Endotracheal