2011 OPEN FORUM Abstracts
VENTILATOR ASSOCIATED PNEUMONIA IN LOW BIRTH WEIGHT NEONATES AT A NEONATAL INTENSIVE CARE UNIT - A FIVE-YEAR RETROSPECTIVE STUDY IN ONE MEDICAL CENTER.
Shih H. Chu1, Hsiu L. Chen1,2, Hsing I. Tseng2, San N. Yang2, Hui C. Fan3, Shah H. Chou4; 1Respiratory Therapy, Kaohsiung Medical University, Kaohsiung, Taiwan; 2Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 3Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 4Chest Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Objective: To determine the clinical characteristics and risk factors of development of ventilator-associated pneumonia (VAP) in low birth weight (LBW) neonates in a neonatal intensive care unit (NICU). Patients and Methods: We conducted a five-year retrospective study to review the data of the neonates with birth weight less than 2500 grams who were admitted to the NICU of Kaohsiung Medical University Hospital between Jan. 2005 and Dec. 2009. For the diagnosis of VAP, the patient was required to have received at least 48 hours of mechanical ventilation and developed a new radiographic evidence of pneumonia. Characteristics of patients with VAP and without VAP were compared using student t tests for numerical data and Chi-square tests for categorical data. Univariate and multiple logistic regression analysis were performed to explore the risk factors related to VAP in LBW neonates in NICU. Results: There were 605 LBW neonates (15 with VAP, and 590 without VAP) admitted to our NICU for at least 48 hours during the period of Jan. 2005 and Dec. 2009. The percentage of male gender, multiple gestations, and the use of human milk were not different between the two groups. There were significant lower gestational age (27.1 +/- 2.3 vs. 33.1 +/- 3.2 weeks), lower birth weight (944.4 +/- 268.4 vs. 1774.2 +/- 451.8 grams), and longer use of endotracheal tube (58.7 +/- 39.6 vs. 1.8 +/- 8.6 days) in patients with VAP than patients without VAP. Univariate analysis revealed that factors related to VAP were less gestational age, lower birth body weight, higher NTISS scores, lower Apgar scores at 1 minute and 5 minutes, the placement of peripheral inserted central catheter and endotracheal tube, and use of total parenteral nutrition. After multiple logistic regression analysis, the most significant risk factors related to VAP in LBW neonates was the days of insertion of endotracheal tube. Conclusion: VAP is still a problem in LBW with use of endotracheal tube in our NICU. The most significant risk factors related to VAP in LBW neonates was the days of insertion of endotracheal tube. Additional studies to develop strategy to prevent VAP are necessary.
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