Reducción de incidencia de neumonía asociada a ventilación mecánica post cirugía cardíaca: experiencia de 13 años de vigilancia epidemiológica en un hospital universitario

Ajenjo, M. Cristina; Zambrano, Alejandra; Eugenin, María I;  Achurra,  Pablo; Zalaquett, Ricardo; Irarrázaval, Manuel J; de la Cerda, Gabriela; Fernández, Paula; Barañao, Miriam; Fuentealba, Patricia; Ferres, Marcela; García, Patricia; Pérez, Carlos; Labarca, Jaime

Keywords: ventilator-associated pneumonia, surveillance, cirugía cardíaca, neumonía asociada a ventilación mecánica, vigilancia epidemiológica, heart surgery

Abstract

Objectives: To report the results of 13 years worth of epidemiologic surveillance of ventilator-associated pneumonia (VAP) following heart surgery and the main interventions applied in order to reduce VAP incidence. Methods: This is a retrospective and descriptive study of active epidemiologic surveillance of VAP. National diagnostic criteria were used. Interventions associated with a decrease in VAlP incidence in adults who underwent heart surgery are described. Results: A significant and sustained reduction was observed in the rate of VAP; being 56.7 per 1,000 ventilator-days in 1998 vs 4.7 per 1,000 ventilator-days in 2010 (p < 0.001). The strongest reduction was observed following 2003 (34.4 to 14.8 per 1,000 ventilator-days in 2004, p < 0.001). The interventions with greatest impact were the implementation of an early-weaning protocol, the introduction of trained nurses to perform the mechanical ventilator equipment management and the routine use of alcohol-based hand rubs. Conclusion: Epidemiologic surveillance associated with the establishment of a multifactorial intervention program applied in collaboration with the attending team, have demonstrated a significant reduction of VAP incidence after heart surgery.

Más información

Título de la Revista: REVISTA CHILENA DE INFECTOLOGIA
Volumen: 30
Número: 2
Editorial: Sociedad Chilena de Infectología
Fecha de publicación: 2013
Página de inicio: 129
Página final: 134
URL: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-10182013000200002&lng=en&nrm=iso&tlng=en
DOI:

10.4067/S0716-10182013000200002