Impacto da implantação de um guia terapêutico para o tratamento de pneumonia nosocomial adquirida na unidade de terapia intensiva em hospital universitário

Abstract

Objective: To evaluate the impact that the implementation of therapeutic guidelines has on the empirical treatment of nosocomial pneumonia. Methods: A clinical trial, using historical controls and involving current ICU patients who had acquired nosocomial pneumonia, was carried out from June of 2002 to June of 2003. All were treated according to therapeutic guidelines developed by the Commission for Nosocomial Infection Control of the institution (group with intervention). As controls, the medical charts of the patients who acquired nosocomial pneumonia between June of 2000 and June of 2001 (group without intervention) were analyzed. Mortality and mean treatment period, as well as the length of hospital and ICU stays, were determined for the patients who acquired nosocomial pneumonia. Results: Mortality associated with pneumonia was lower in the group treated according to the therapeutic guidelines (26 vs. 53.6%; p = 0.00). As for overall mortality, there was no statistically significant difference between the two periods (51 vs. 57.9%; p = 0.37). There was also no difference in the type of microorganisms isolated, treatment period, length of hospital stay or length of ICU stay. Conclusion: The implementation of therapeutic guidelines for the treatment of nosocomial pneumonia acquired in the ICU can be efficacious in decreasing mortality rates.

Análise de correlação entre escore apache II e complicações respiratórias em pacientes vítimas de TCE na UTI

“…Estudos recentes apontam a pneumonia hospitalar como uma das complicações pulmonares mais comuns na UTI, enquanto a PAVM é um subgrupo da pneumonia hospitalar que ocorre até 48h a partir da entubação, que não estava incubada no período de admissão do paciente, e 72h após a extubação (GARCIA ET al, 2007;ROCCO, 2001).…”