PICU机械通气呼吸机管路的病原学分析

PICU机械通气呼吸机管路的病原学分析王文超;张玉侠;贺骏;胡静;郑冬;侯添彧(PICU)经鼻或经口气管插管行有创通气的患PICU4248h71420(47.62%)1008210株。下呼吸道]PICUPICU《护理研究》2016(030)033【总页数】5页(P4198-4201,4201)【关键词】儿童;机械通气;病原学分析;呼吸机相关性肺炎;PICU【作者】王文超;张玉侠;贺骏;胡静;郑冬;侯添彧【作者单位】201102，复旦大学附属儿科医院;201102;201102;201102复旦大学附属儿科医院;201102【正文语种】中文【中图分类】R473.72PICU201512015575呼吸机。排除上机后7d3342例。2418216(3.33±3.9621.17d±16.00d；66.7%,方法h714320min内立刻送检至检验科。检验科人员48h,48h48h7141999年中华医学会呼吸病学分会48h后发病；>10.0×109/L<4.0×109/L。伴或不伴核左移；体温>38.0新的病原体。统计学方法采用SPSS19.0P<0.05为差异有统计学意义。47.62%1100821014763275%以上与在呼吸机管路中培养得到的细菌菌种相同。通过一致性Y38.46%,比比较差异有统计学意义(χ2=8.501,P=0.037)。3)加强呼吸机管道的规范化管理4247.62%,Y752.4%73没有明显差异72Meta7d1d～3d7d～14d发病率7d换较为合适。48h14推进呼吸机相关性肺炎预防的集束化护理策略[830°～45°8h1pH[9]器进行气道湿化；呼吸机管道有明确污染时进行管道更换；采用持续的声门下吸引。根据美国医疗改进中心的建议,预防呼吸机相关性肺炎的集束化干预策略包括床头抬高、口腔护理、镇静唤醒、消化道溃疡的预防和深静脉栓塞的预防。2222.6%～45.1%[11]31%～57%,42【相关文献】EdwardsJP,PetersonKD，AndrusML.NationalHealthCaresafetyNetwork(NHSN)report,datasummaryfor2006[J].AmJInfectControl,2007,35(5):290-301.SamransamruajkitR,JirapaiboonsukS,SiritantiwatS,etal.Effectoffrequencyofventilatorcircuitchanges(3vs7days)ontherateofventilator-associatedpneumoniaPICU[J].JournalofCriticalCare,2010,25(1):56-61.王晓艳.ICU,2010:1.2010,25(12):1092-1093.RelloJA,LisboaET.Acarebundleapproachforpreventionofventilator-associatedpneumonia[J].ClinicalMicrobiologyandInfection,2013,19(4):363-369.Meta分析杂志，2011,21(12):1471-1475.ChoiJS,YeonJH.Ventilator-associatedpneumoniawithcircuitchangesevery7versusevery14days[J].JournalofKoreanAcademyofNursing,2010,40:799-807.CasonCL,TynerS.Nurses’implementationofguidelinesforassociatedpneumoniafromthecenterfordiseasecontrolandprevention[J].AmJCare,2007,16(1):28-36.HeylanclDK,DroverJW,MacDonaldS,etal.Effectofpostpyloricfeedingongastroesophagealregurgitationandpulmonarymicroaspiration:esultsofarandomizedcontrolledtrial[J].CritCareMed,2001,29(8):1495-1501.ChendrasekharA,TimberlakeG.Endotrachealtubecuffpressurethresholdpreventionofnosocomialpneumonia[J].JApplRes,2003,3(3):311-314.LabeauS,VandijckD,RelloJ,etal.Evidence-basedguidelinesforthepreventionventilator-associatedpneumonia:resultsofaknowledgetestamongEuropeanintensivecarenurses[J].JHospInfect,2007,70(2):180-185.GastmeierP.Preventionofventil