ЭФФЕКТИВНОСТЬ ПРОТОКОЛА ПРОФИЛАКТИКИ РАЗВИТИЯ  НОЗОКОМИАЛЬНОЙ ПНЕВМОНИИ, СВЯЗАННОЙ С ИСКУССТВЕННОЙ  ВЕНТИЛЯЦИЕЙ ЛЕГКИХ

А.К. Moldotashova; Zh.S. Derkembayeva; K.S. Zhuzumalieva; Zh.A. Kochkonbayev; V.K.  Shukurova

doi:10.54890/.v5i5-6.450

А.К. Moldotashova Zh.S. Derkembayeva K.S. Zhuzumalieva Zh.A. Kochkonbayev V.K. Shukurova

DOI:

Abstract

Purpose of the study. Evaluation of the frequency and severity of nosocomial pneumonia associated with artificial lung ventilation in patients in the intensive care unit with and without specialized means for oral care and sanitation of the tracheobronchial tree.
Methods: 60 ICU pts were included in RCT. The reason of invasive mechanical ventilation was the depression of consciousness due to stroke or head injury. The pts were randomized to VAP prophylaxis bundle group 1 or to standard care group 2. In first group we used bundle including filter and HME, disposable breathing circuits for ventilators. The oral care performed 3 time per 24 hours with visual inspection, 0,05% chlorhexidine solution washing, dental and gun cleaning, only closed system aspiration.
Results: Nosocomial pneumonia (NP) prophylaxis bundle decrease early onset NP - 6.6 and 33% in 1 and 2 groups respectively (p = 0.00167), increase VAP free-day - 7.5 ± 4.6 day in 1 group and 5.3 ± 6.5 day, (p = 0.00182) in group 2; decrease severity of NP - CPIS on day 7 was 5.96 ± 3.2 and 7.2 ± 2.43 in 1 and 2 groups (p = 0.046), P/F on day 7 - 304.84 ± 22 and 255.9 ± 43 in 1 and 2 groups (p = 0.001).
Microbiology data show decrease of CFU colonization Klebsiella pneumoniae from 106 to 104 (p < 0.001), Streptococcus pneumoniae from 107 to 103 (p < 0.001), MRSA from 105 to 103 (p < 0.001), Proteus mirabilis from 107 to 103 (p < 0.001).

Conclusions: VAP prophylaxis bundle decrease “early onset” VAP, severity of VAP,increase VAP free day.

Keywords:

Nosocomial pneumonia, intensive care unit, nosocomial ventilator-associated pneumonia, intensive care unit, prevention of pneumonia, prophylaxis bundle.

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