A CLINICAL STUDY OF VENTILATOR ASSOCIATED PNEUMONIA IN A TERTIARY CARE CENTER

Abstract

Introduction: Ventilator-associated pneumonia (VAP) is a nosocomial pneumonia in mechanically ventilated patients that develops 48hours after initiation of mechanical ventilation. Despite recent advances VAP complicates 8-28% of the patients receiving mechanical ventilation.1-5 Objectives: To determine the incidence, risk factors, clinical prole and outcome of VAP in a tertiary care hospital. Methods: 100 children between 1 month to 12 years of age who received mechanical ventilation for >48hours in PICU King George Hospital were enrolled in the study. The demographic details of the patients, underlying illness, duration of ventilation, medications administered and investigations performed and outcome of these children was noted. Results: Majority of children with VAP had a Clinical Pulmonary Infection score (CPIS) of>8.Incidence of VAP was 26%. Statistically signicant difference was found with VAP in association with factors like purulent aspirate, un-cuffed ET tube, multiple intubations, and duration of mechanical ventilation>5days with gram negative bacilli(Acinetobacter and klebsiella) being the important causative agents. Conclusion: Awareness about the risk factors & their prevention will help in reducing VAP related morbidity and mortality. Early institution of empirical sensitive antibiotics improves outcomes in children with VAP and also helps to prevent the risk of multidrug resistance