A Study to Find out Incidence, Etiology, Diagnosis and Outcome of Ventilator Associated Pneumonia

Abstract

Background: Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs 48-72 hours or thereafter following endotracheal intubation. VAP contributes to approximately half of all cases of hospital-acquired pneumonia . VAP is estimated to occur in 9-27 % of all mechanically ventilated patients. Hence the present study was undertaken to study incidence, etiology, diagnosis and outcome VAP.

Methods: A total of 100 patients who will be kept on mechanical ventilator will be selected in an intensive care unit (ICU). Cases included will be patients of both sexes who were kept on mechanical ventilator for more than 48 h, having the age of >14 years. Informed Written consent will be obtained from all the study subjects. A detailed clinical evaluation including thorough history, physical and general examination will be done on each subject.  Growth >105 CFU/ml was taken as the cut-off threshold for ETAs while growth >104 CFU/ml was taken as the cut-off for BAL. All patients who will be included in the study will be monitored at frequent intervals (every three days) for the development of VAP using clinical and microbiological criteria until either discharge or death. The clinical parameters will be recorded from their medical records and bedside charts. Details of antibiotic therapy, surgery, use of steroids, duration of hospitalization, presence of neurological disorders, and impairment of consciousness will also be noted. 

Results: Out of 100 patients VAP was found to be in 43 patients . in early onset VAP pseudomonas aeruginosa and acinetobactor baumanii are the chief causative organisms (36% each) .in late onset VAP pseudomonas, klebsiella were most common causative organisms(52% each) followed by acinetobactor baumanii.

Conclusions: This proves that non-invasive ventilatory support is an effective tool in the management of acute exacerbation of COPD.