Volume 24, Issue 10 (Jan 2017)                   JSSU 2017, 24(10): 818-827 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

HosseiniShirazi M, Alipour A, Firouzian A, Darvishi Khezri H, Omrani Nava M. Comparing sedationreceive as blouse and infusion at incidence of ventilator-associated pneumonia in intubated traumatic patients in ICU. JSSU. 2017; 24 (10) :818-827
URL: http://jssu.ssu.ac.ir/article-1-3936-en.html
Abstract:   (4829 Views)

Introduction: Ventilator-associated pneumonia (VAP) is one of the most important complications of mechanical ventilation and cause of mortality in traumatic patients under mechanical ventilation admitted in the ICU (intensive care unit). The aim of current study was  comparing sedationreceived as bolus and infusion at incidence of VAP in intubated traumatic patients in the ICU.

Methods: This study was a prospective descriptive-analytical one. Current study was carried out on the patients under mechanical ventilation admitted to ICUs in Imam Khomeini hospital of Sari city, from September 2015 to September 2016. Inclusion criteria  included traumatic patients older than 18 years admitted to the ICU and under mechanical ventilation for more than 48 hours. In addition to demographic data, patients' clinical information  was daily recorded. Patients’ followed-up was continued until discharge from the ICU, ventilator weaning or death.

Results: total of 2304 patients were admitted to the ICU, of which 186 traumatic patients under mechanical ventilation longer than 48 hours were reviewed and analyzed. Among 66 traumatic patients receiving sedation(82.8%), 66 patients (42.9%) as blouse, and 42 patients (27.3%) as infusion had received sedationdrug. The incidences of VAP in the patients receiving sedationas bolus or infusion were 6.1% and 52.4%, respectively. The comparison of VAP incidence among the patients receiving sedationas bolus and infusion, showed a significant difference (p<0.005).

Conclusion: Sedative injection as infusion and continuous for more than 24 hours can remarkably increase incidence of VAP in traumatic patients under mechanical ventilation in the ICU in comparison to the sedation injection as blouse. Therefore, paying attention to this risk factor for controlling and reducingthe incidence of VAP is necessary in these patients.

Full-Text [PDF 1511 kb]   (904 Downloads)    
Type of Study: Original article | Subject: General
Received: 2016/10/23 | Accepted: 2016/12/10 | Published: 2017/01/29

1. Darvishi Khezri H. The role of oral care in prevention of ventilator associated pneumonia: a literature review. J Shahid Sadoughi Univ Med Sci 2014; 21(6): 840-49. [Persian]
2. Wang L, Li X, Yang Z, Tang X, Yuan Q, Deng L, et al. Semi-recumbent position versus supine position for the prevention of ventilator‐associated pneumonia in adults requiring mechanical ventilation. The Cochrane Library 2016; (1): 1-55.
3. Darvishi Khezri H, Tahmassebi H. Evaluation the Effects of Chlorhexidine Mouthwash on the Ventilator Associated Pneumonia: Pathogens, Incidence and Mortality. Arak Med Univ J 2015; 17(10): 41-9 [Persian]
4. Guillamet CV, Kollef MH. Update on ventilator-associated pneumonia. Current opinion in critical care 2015; 8(21): 430-38.
5. Leonard KL, Borst GM, Davies SW, Coogan M, Waibel BH, Poulin NR, et al. Ventilator-Associated Pneumonia in Trauma Patients: Different Criteria, Different Rates. Surgical infections 2016; 17(3): 363-68.
6. Darvishi Khezri H, Gorji MAH, Morad A, Gorji H. Comparison of the antibacterial effects of matrica & Persica and chlorhexidine gluconate mouthwashes in mechanically ventilated ICU patients: a double blind randomized clinical trial. Rev Chilena Infectol 2013; 30(4): 368-73.
7. Coplin WM, Pierson DJ, Cooley KD, Newell DW, Rubenfeld GD. Implications of extubation delay in brain-injured patients meeting standard weaning criteria. American J Respiratory Critical Care Med 2000; 161(5): 1530-36.
8. Rello J, Ollendorf DA, Oster G, Vera-Llonch M, Bellm L, Redman R, et al. Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. CHEST J 2002; 122(6): 2115-21.
9. Darvishi Khezri H, Emami Zeydi A, Firouzian A, Gholipour Baradari A, Mahmoodi G, Hasanzadeh-Kiabi F, et al. The Importance of oral hygiene in prevention of ventilator-associated pneumonia (VAP): A literature review. Inter J Caring Sci 2014; 7(1): 12.
10. Mangram AJ, Sohn J, Zhou N, Hollingworth AK, Ali-Osman FR, Sucher JF, et al. Trauma-associated pneumonia: time to redefine ventilator-associated pneumonia in trauma patients. American J Surg 2015; 210(6): 1056-62.
11. Smith MA, Hibino M, Falcione BA, Eichinger KM, Patel R, Empey KM. Immunosuppressive aspects of analgesics and sedatives used in mechanically ventilated patients an underappreciated risk factor for the development of ventilator-associated pneumonia in critically Ill patients. Ann Pharmacotherapy 2014; 48(1): 77-85.
12. Hashemian M, Talaie H, Akbarpour S, Mahdavinejad A, Mozafari N. Central Nervous System Depressants Poisoning and Ventilator Associated Pneumonia: An Underrated Risk Factor at the Toxicological Intensive Care Unit. Iranian Red Crescent Med J 2016; 18(1).
13. Six S, Jaffal K, Ledoux G, Jaillette E, Wallet F, Nseir S. Hyperoxemia as a risk factor for ventilator-associated pneumonia. Critical Care 2016; 20(1): 195.
14. Ensminger SA, Wright RS, Baddour LM, Afessa B, editors. Suspected ventilator-associated pneumonia in cardiac patients admitted to the coronary care unit. Mayo Clinic Proceedings; 2006: Elsevier.
15. Bornstain C, Azoulay E, De Lassence A, Cohen Y, Costa MA, Mourvillier B, et al. Sedation, sucralfate, and antibiotic use are potential means for protection against early-onset ventilator-associated pneumonia. Clinical infectious diseases 2004; 38(10): 1401-08.
16. Kollef MH, Levy NT, Ahrens TS, Schaiff R, Prentice D, Sherman G. The use of continuous iv sedation is associated with prolongation of mechanical ventilation. CHEST J 1998; 114(2): 541-48.
17. Kress JP, Pohlman AS, O'Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. New England J Med 2000; 342(20): 1471-77.
18. Yepes D, Gil B, Hernandez O, Murillo R, Gonzalez M, Velasquez JP. Ventilator associated pneumonia and transfusion, is there really an association?(the NAVTRA study). BMC pulmonary med 2006; 6(1): 1.
19. Luna CM, Blanzaco D, Niederman MS, Matarucco W, Baredes NC, Desmery P, et al. Resolution of ventilator-associated pneumonia: Prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome. Critical care med 2003; 31(3): 676-82.
20. Zilberberg MD, Shorr AF. Ventilator-associated pneumonia: the clinical pulmonary infection score as a surrogate for diagnostics and outcome. Clinical infectious diseases 2010; 51(Supplement 1): S131-S5.
21. Michetti CP, Prentice HA, Rodriguez J, Newcomb A. Supine position and nonmodifiable risk factors for ventilator-associated pneumonia in trauma patients. The American J Surg 2016; [In Press]
22. Stephan F, Mabrouk N, Decailliot F, Delclaux C, Legrand P. Ventilator-associated Pneumonia Leading to Acute Lung Injury after TraumaImportance of Haemophilus influenzae. the American Soc Anesthesiologists 2006; 104(2): 235-41.
23. Bochicchio GV, Napolitano L, Joshi M, Bochicchio K, Shih D, Meyer W, et al. Blood product transfusion and ventilator-associated pneumonia in trauma patients. Surgical Infections 2008; 9(4): 415-22.
24. Li Z, Qi J, Zhao X, Lin Y, Zhao S, Zhang Z, et al. Risk-Benefit Profile of Gastric vs Transpyloric Feeding in Mechanically Ventilated Patients A Meta-Analysis. Nutrition in Clinical Practice 2016;31(1):91-8.
25. Bouza E, Pérez A, Muñoz P, Pérez MJ, Rincón C, Sánchez C, et al. Ventilator-associated pneumonia after heart surgery: a prospective analysis and the value of surveillance. Critical Care Med 2003; 31(7): 1964-70.
26. Jovanovic B, Milan Z, Markovic-Denic L, Djuric O, Radinovic K, Doklestic K, et al. Risk factors for ventilator-associated pneumonia in patients with severe traumatic brain injury in a Serbian trauma centre. Inter J Infectious Dis 2015; 38: 46-51.
27. Miyawaki T, Sogawa N, Maeda S, Kohjitani A, Shimada M. Effect of midazolam on interleukin-6 mRNA expression in human peripheral blood mononuclear cells in the absence of lipopolysaccharide. Cytokine 2001; 15(6): 320-27.
28. Joseph NM, Sistla S, Dutta TK, Badhe AS, Parija SC. Ventilator-associated pneumonia in a tertiary care hospital in India: incidence and risk factors. J Infection in Developing Countries 2009; 3(10): 771-77.
29. Bornstain C, Azoulay E, De Lassence A, Cohen Y, Costa M, Mourvillier B, et al. Sedation, sucralfate, and antibiotic use are potential means for protection against early-onset ventilator-associated pneumonia. Clinical infectious diseases 2004; 38(10): 1401-08.
30. Lepelletier D, Roquilly A, Mahe PJ, Loutrel O, Champin P, Corvec S, et al. Retrospective analysis of the risk factors and pathogens associated with early-onset ventilator-associated pneumonia in surgical-ICU head-trauma patients. J neurosurgical anesthesiology 2010; 22(1): 32-7.

Add your comments about this article : Your username or Email:

Send email to the article author

© 2019 All Rights Reserved | SSU_Journals

Designed & Developed by : Yektaweb