Comprehensive airway management of ventilator-associated pneumonia in ICU populations

重症监护病房患者呼吸机相关性肺炎的综合气道管理

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Abstract

OBJECTIVE: To evaluate the validity of comprehensive airway management intervention on ventilator-associated pneumonia (VAP) in ICU patients requiring mechanical ventilation. METHODS: In this retrospective observational study, the clinical data from 120 patients undergoing mechanical ventilation in the ICU of Hebei Chest Hospital from May 2020 to July 2022 were surveyed. Finally, 50 cases of VAP were identified and placed into an observation (n=25) and a control group (n=25) according to the nursing model they received. The control group was treated with routine nursing intervention, and the observation group was given comprehensive airway management intervention based on the control group. After 3 weeks of intervention, the clinical symptom recovery time, treatment-related indexes, nursing quality and nursing satisfaction score, and blood gas indexes and vital signs of the patients in the two groups were examined. The multivariate Logistic regression analysis was performed to identify the risk factors related to the death of critically ill patients. RESULTS: The observation group showed a significant reduction in the recovery time of heart failure, wheezing cough, and lung rales compared with that in the control group. The duration of mechanical ventilation, hospitalization, and antibiotic use in the observation group were appreciably shorter compared with those in the control group (all P<0.05). Additionally, nursing satisfaction and nursing quality scores were higher in the observation group compared to the control group (P<0.05). The contrast of blood gas indexes and vital signs between the two groups before ventilation and 1 hour after evacuation ventilation showed that a statistical significance existed in the interaction between groups (P<0.05). The risk factors related to the death of critically ill patients included D-dimer (OR=1.051, 95% CI: 1.006-1.08, P<0.05) and lactic acid (OR=0.894, 95% CI: 0.923-1.031, P<0.05). CONCLUSION: Comprehensive airway management mode can reduce the occurrence of VAP in ICU patients requiring mechanical ventilation.

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