VENTILATION-ASSOCIATED PNEUMONIA AS A COMPLICATION AMONG PATIENTS IN THE INTENSIVE CARE UNIT

Abstract

Ventilation - associated pneumonia is a life-threatening complication of patients in the intensive care unit, which significantly worsens the condition of patients and often leads to a fatal outcome. Most often, it occurs in patients with long-term mechanical ventilation of lungs, who are in a critical condition. The purpose of our study was to present the etiology, epidemiology, and pathogenesis of ventilation-associated pneumonia, and to introduce basic and innovative methods of prevention and diagnosis of this complication. It was revealed that among 29 people who died from intracerebral hemorrhages in the intensive care unit, 12 (41,4%) had the development of this complication. Basically, ventilatorassociated pneumonia occurred in the form of bronchopneumonia, interstitial and aspiration pneumonia of mixed etiology: nosocomial gram-negative bacteria and normal oral microflora. The diagnostic research was done by using bronchoscopy, multispiral computed tomography, and chest radiography. To identify infectious agent used the method of bacterial culture, polymerase chain reaction, enzyme-linked immunosorbent assay and immunochromatographic tests of mucus. Regardless of the form of ventilator-associated pneumonia, the pathoanatomic examination revealed its macroscopic signs, confirmed by the results of histological examination. Reducing the risk of nosocomial pneumonia to a certain extent can be achieved by reducing the time of forced ventilation with the use of modern principles of "sparing" artificial ventilation, maintaining spontaneous respiratory activity while maintaining the cough reflex, observing basic sanitary and hygienic standards when interacting with the patient and the requirements of asepsis when working with vascular and catheters during bronchoscopy.

Keywords

nosocomial pneumonia / intensive care unit / ventilation-associated pneumonia / etiology / pathogenesis / morphology

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RIGHTS & PERMISSIONS

Dovgan Y.G., Troitskaya A.S.