دانلود رایگان مقاله انگلیسی بررسی عوامل خطرساز پنومونی مرتبط با تهویه مطبوع در بیماران دچار خونریزی حاد مغزی - هینداوی 2017

Ventilator-associated pneumonia (VAP) is a predominant factor of pulmonary infection. We analyzed the risk factors of VAP with acute cerebral hemorrhage in intensive care unit (ICU) by univariate and multivariate logistic regression analyses. After comparison of 197 cases of the VAP and non-VAP patients, we found that age > 65 years (P � 0.003), smoke (P � 0.003), coronary heart disease (P � 0.005), diabetes (P � 0.001), chronic obstructive pulmonary disease (COPD) (P � 0.002), ICU and hospital stay (P � 0.01), and days on mechanical ventilation (P � 0.01) were signi:cantly di;erent, indicating that they are risk factors of VAP. All the age > 65 years (OR = 3.350, 95% CI = 1.936–5.796, P ≤ 0.001), smoke (OR = 3.206, 95% CI = 1.909–5.385, P ≤ 0.001), coronary heart disease (OR = 3.179, 95% CI = 1.015–4.130, P � 0.017), diabetes (OR = 5.042, 95% CI = 3.518–7.342, P ≤ 0.001), COPD (OR = 1.942, 95% CI = 1.258–2.843, P � 0.012), ICU and hospital stay (OR = 2.34, 95% CI = 1.145–3.892, P � 0.038), and days on mechanical ventilation (OR = 1.992, 95% CI = 1.107–3.287, P � 0.007) are independent risk factors of VAP. After observation of patients with 6 months of follow-up, the BI score was signi:cantly lower in VAP than that in non-VAP, and the rebleeding rate and mortality rate were signi:cantly higher in VAP than those in non-VAP. )us, the prognosis of the patients with acute cerebral hemorrhage and VAP in ICU is poor.

4. Discussion

With the accelerated process of aging, the incidence of cerebrovascular disease in China increased with year and has the trend of rejuvenation, which is a serious threat to people’s health [21]. Ventilator-associated pneumonia (VAP) is one of the most common complications after treatment of acute cerebral hemorrhage [3–5]. )e serious pulmonary infection directly a;ects the prognosis of patients and even leads to death. Cerebral hemorrhage is a common disease that seriously damages people’s health and life. )e cerebral hemorrhage patients with more serious illness often entered the ICU. )e study showed that patients are prone to VAP. )is study showed 197 cases of acute cerebral hemorrhage patients. Among them, 82 cases are VAP, with the incidence of 41.6%, showing a very high incidence of VAP in ICU patients with acute cerebral hemorrhage. )is might be due to the occurrence of a stress state in patients with acute cerebral hemorrhage, which increased the susceptibility to infection of VAP by decreasing the body resistance, inducing intracranial hypertension, a;ecting the thalamic function and the autonomic nerve function disorder, and inducing pulmonary hypertension and pulmonary capillary congestion. In addition, ICU is the gathering place of critically ill patients and the most serious hospital infection [22, 23]. We observed that the BI score was signi:cantly lower in VAP than that in non-VAP. )e rebleeding rate and mortality rate were signi:cantly higher in VAP than those in non-VAP. It was suggested that VAP can seriously a;ect the prognosis of patients with acute cerebral hemorrhage; therefore, early clinical prevention has an important clinical value in patients su;ering from cerebral hemorrhage VAP. Our results showed that age > 65 years, smoke, coronary heart disease, diabetes, chronic obstructive pulmonary disease (COPD), ICU and hospital stay, and days on mechanical ventilation were risk factors of VAP. )e respiratory physiological function in the elderly decreased gradually with the increase of age, the muscle of the respiratory muscle gradually shrank, the elasticity of the lung tissue decreased gradually, and the cough and expectoration movement decreased signi:cantly [24–26].