Ventilators in ICU: A boon or burden

Mehndiratta, Man Mohan; Nayak, Ranu; Ali, Safina; Sharma, Ajay; Gulati, Nitya

doi:10.4103/0972-2327.167706

Cited by 9 publications

(10 citation statements)

References 23 publications

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“…Higher incidence of VAP has been reported in patients with neurocritical illness [15]. In our study, 18.9% (20/106) of the VAP cases were initially admitted to ICU due to neurological disease.…”

Section: Discussionmentioning

confidence: 53%

Epidemiology and Outcome of Ventilator-Associated Pneumonia in a Heterogeneous ICU Population in Qatar

Ali

Khan

George

et al. 2016

BioMed Research International

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Objective. The purpose of this study is to collect data on epidemiology, microbiology, and outcome of VAP in our ICUs for reevaluation of the therapeutic strategies. Methods. This retrospective study involved all adult patients, 15 years of age or older, diagnosed with VAP in multidisciplinary ICUs at Hamad General Hospital between January 2010 and December 2012. Results. A total of 106 patients were enrolled. The mean incidence of VAP was 5.0 per 1000 ventilator-days. It was predominant among younger age group (<60 years), male patients (80.2%), and trauma ICU admissions (49.0%). The most common comorbidity was hypertension (34%) and polytrauma (36.8%) was the most frequent admission diagnosis. 30-day mortality was 23.6% and it was significantly higher in ≥60 years age group, female gender, patients with diabetes mellitus, hypertension, chronic respiratory disease, ≥1 comorbidity, and poor functional status, smokers, medical and surgical ICU admissions, and patients with previous stay in medical/surgical wards, inappropriate empirical therapy, and admission diagnosis of respiratory failure. Gram-negative bacilli were the most frequent respiratory specimen isolates, Pseudomonas spp. being the most common. Majority of our Acinetobacter isolates were multidrug resistant. Conclusion. The incidence of VAP in our ICUs was low. Higher mortality rates were observed in certain subgroup of patients. Resistance to commonly used antimicrobials is likely to require reevaluation of the therapeutic strategies at our institution.

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Section: Discussionmentioning

confidence: 53%

Epidemiology and Outcome of Ventilator-Associated Pneumonia in a Heterogeneous ICU Population in Qatar

Ali

Khan

George

et al. 2016

BioMed Research International

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“…14 15 In a study from North India, Mehndiratta, et al have reported isolates of Pseudomonas, Klebsiella and E. coli with 100% sensitivity to imipenem and all the gram-positive isolates studied were sensitive to linezolid. 16 In this study,the most effective antibiotic against gram negative bacilli was found to be Imipenem followed by Piperacillin tazobactam. An Indian study by Patil have reported Piperacillin Tazobactam, amikacin, and meropenem as good antibiotic options for VAP to start with till culture reports are available.…”

Section: Discussionmentioning

confidence: 70%

A Study on Bacterial Etiology of Ventilator Associated Pneumonia and its Antimicrobial Pattern

Narayanan¹,

Rajan²,

Sasikala³

et al. 2018

IJCMR

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Introduction: Ventilator Associated Pneumonia(VAP) remains a major cause of mortality and morbidity among critical ill patients. An imbalance between normal host defenses and the ability of microorganisms to colonize and invade the lower respiratory tract results in hospital acquired pneumonia. Aims and objectives were to isolate and identify bacterial pathogens from VAP and to determine their antibiogram. Material and Methods:A total of 66 Endotracheal aspirates were included in this study. 0.01 ml of sample was inoculated onto Blood agar,Chocolate agar and MacConkey agar and plates were incubated overnight at 37°C for 24 and 48 hours. Bacterial isolates were identified by standard biochemical tests. Antimicrobial sensitivity testing was performed on Muller Hinton Agar by Kirby Bauer disk diffusion and interpreted as per the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The occurrence of VAP was more common in the age group of 18-30 years (46.51%). Of the total cases 59.09% showed monomicrobial growth and 6.06% showed polymicrobial growth. The predominant gram negative isolate obtained was Klebsiella sp (68.89%) followed by Acinetobacter sp(15.56%) and Pseudomonas aeruginosa (13.33%). Among the Gram negative bacilli, 24.44% were resistant to Piperacillin Tazobactam and 35.56% to Cefoperazone sulbactam and 31.11% isolates were resistant to meropenem.All gram negative isolates were sensitive to Imipenem. Conclusion: Knowledge on incidence of VAP, its etiology and susceptibility patterns is essential to initiate the empirical antibacterial therapy for patients on mechanical ventilation

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“…[23] Increased VAP incidence has been observed in patients with neurological disorders. [24] In our study, 14.46% (23/159) of the VAP patients were admitted due to neurological disease and 30-day mortality in these patients was 47.8% (11/23). Our study shows that the incidence of VAP decreased over the years due to awareness and better management strategies.…”

Section: Discussionmentioning

confidence: 99%