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KMID : 0361720090200020123
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Korean Journal of perinatology
2009 Volume.20 No. 2 p.123 ~ p.131
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Clinical Features and Outcomes of Ventilator-Associated Pneumonia in Neonatal Intensive Care Unit Patients
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Pakr Jae-Hyun
Kim Chun-Soo
Lee Sang-Lak
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Abstract
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Purpose: This study was undertaken to investigate clinical features and outcomes of ventilatorassociated
pneumonia (VAP) in neonatal intensive care unit (NICU) patients.
Methods: Retrospective analysis of medical records was conducted on 176 patients who were ventilated with endotracheal intubation for 48 hours and over in a NICU over a 3-year period (2005~2007).
Results: There were 29 episodes of VAP (16.5%). The main pathogens were Gram-negative bacilli(69%). Patients with VAP had a higher incidence of sepsis (58.6% vs. 34.7%) and bronchopulmonay dysplasia (65.5% vs. 23.1%), and had prolonged duration of hospital stay (median: 86 days vs. 39days), and also showed higher mortality (41.3% vs. 23.8%). By logistic regression analysis, there were two independent-predicting factors for VAP: reintubation of endotracheal tube (OR: 9.3, 95% CI: 2.2~40.1) and patent ductus arteriosus (OR: 2.7, 95% CI: 1.1~7.2).
Conclusion: VAP was associated with poor clinical courses and outcomes in NICU patients, and reintubation of endotracheal tube and patent ductus arteriosus may be risk factors of this infection. Additional studies are necessary to make interventions for preventing VAP in mechanically ventilated neonates.
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KEYWORD
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Ventilator-associated pneumonia, Neonatal intensive care unit
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