• 作者：J. Elorza Mateos^a ; ^{jemateos@alumni.unav.es} ; N. Ania Gonzá ; lez^a ; M. &#193 ; greda Sá ; daba^a ; M. Del Barrio Linares^b ; M.A. Margall Coscojuela^c ; M.C. Asiain Erro^a
• 关键词：Cuidados de enfermer&iacute ; a ; Neumon&iacute ; a asociada a ventilaci&oacute ; n mec&aacute ; nica ; Ventilaci&oacute ; n mec&aacute ; nica ; Unidad de cuidados intensivos ; Prevenci&oacute ; n ; Incidencia de NAVM
• 刊名：Enfermer铆a Intensiva
• 出版年：2011
• 期刊代码：pca155_11302399
• 类别：med
• 出版时间：January-March 2011
• 卷：22
• 期：1
• 页码：22-30
• 文件大小：190 K

ass="h4">Introduction

Certain nursing interventions reduce the incidence of ventilator-associated pneumonia (VAP).

ass="h4">Objectives

a) to analyze in patients with more than 24 hours of invasive mechanical ventilation how frequently oral hygiene, oropharyngeal suction, turning and evaluation of the tolerance of enteral nutrition were performed according to established protocols; b) to record in these same patients endotracheal tube cuff pressures and the degrees of elevation of the head of the bed (HOB); c) to determine over the three months of the study the incidence density of VAP.

ass="h4">Method

This descriptive study was carried out in 26 patients. The nursing interventions of interest were recorded daily. Furthermore, endotracheal tube cuff pressures and the degrees of elevation of HOB were measured 3 times a day. Compliance with the established protocols was considered good when it reached 鈮?0%. Cases of VAP were determined using CDC criteria. The incidence density was calculated including all the patients (122) with mechanical ventilation during the study period.

ass="h4">Results

Good compliance with the established protocols was achieved for oral hygiene in 23 patients, for oropharyngeal suction and for turning in 19 patients, and in all patients for the evaluation of the tolerance of enteral nutrition. In 214 measurements endotracheal tube cuff pressure was 鈮?20cm H20 and in 121 lower. In 79 measurements elevation of HOB was 鈮?0虋 and in 256 lower. The incidence density of VAP was 7.43/ 1.000 days of mechanical ventilation.

ass="h4">Conclusions

: For these nurse interventions aimed at preventing VAP, levels of compliance with established protocols were satisfactory. The incidence density of VAP was low and well within internationally established ranges. Nevertheless, the incidence of VAP could be further reduced with a better control of cuff pressures and by elevating the HOB to between 30虋 and 45虋.