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M Hosseinishirazi , A Alipour, A Firouzian, H Darvishi Khezri, M Omrani Nava,
Volume 24, Issue 10 (Jan 2017)
Abstract

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.



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