Determinar la tasa de mortalidad en pacientes pediátricos de 2 a 12 mese con neumonía asociada a ventilación mecánica
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2014
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Tecnología Médica
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La neumonía asociada a ventilación mecánica es una infección intrahospitalaria que se manifiesta en pacientes de cuidados intensivos con via aerea artificial, se asocia con altas tasa de morbilidad y mortalidad. Su presencia determina una mayor estancia en cuidados intensivos, elevación de costos, atención y mayor uso de antibiótico. El origen de esta infección es polimicrobiano y principalmente debidas a Pseudomonas aeruginosa y staphylococcus aureus, su pronostico depende del momento de aparicion de los sintomas; secreciones purulentas, leucocitos altos, temopeartura alta y en la radiografia con infiltrados nuevos y persisitentes cuando aparece antes de los 4 dias es precoz y es producida por germenens de la orofaringe y su mortalidad es baja y es tardia cuando aparece despues de los 5 dias producidas por cepas multirrsistentes y de muy mal pronostico. Los principales factores de riesgos son la edad, bajo peso al nacer, días de ventilación, poca movilización entre otros. El protocolo planteado tiene como objetivo reducir y controlar estas infecciones para así evitar que se propagen en el area y disminuir la tasa de mortalidad en los pacientes pediátricos de dicha área. El presente estudio se realizó en la unidad de cuidados intensivos de pediátricos del Hospital del niño Francisco de Icaza Bustamante. Los cuales participaron 120 pacientes de ambos sexo de los cuales se trabajó con una muestra de 86 pacientes. Los resultados demostraron que la tasa de mortalidad fue de 32% frente al 57% que murieron por otras causas y mortalidad cero, de esta forma demostrando que el protocolo planteado resulto eficaz para disminuir la tasa de mortalidad.
The ventilator-associated pneumonia is a nosocomial infection that manifests in intensive care patients with artificial via air, is associated with high morbidity and mortality. Their presence determines a longer stay in intensive care, higher costs, care and increased use of antibiotics. The origin of this infection is polymicrobial and mainly due to Pseudomonas Aeruginosa and Staphylococcus aurous, the forecast depends on the time of onset of symptoms; purulent secretions, high WBC, high temopeartura and radiography with new and persistent infiltrates when he appears before 4 days is early and is produced by germaneness or pharyngeal and mortality is low and is tardy when it appears after 5 days produced by multirresistente very poor prognosis and strains. The main risk factors are age, low birth weight, days of ventilation, poor mobilization among others. The proposed protocol aims to reduce and control these infections in order to prevent propagen in the area and reduce the mortality rate in pediatric patients in that area. This study was conducted in the intensive care unit of the Hospital Pediatric Child Francisco de Icaza Bustamante. This involved 120 patients of both sexes of which worked with a sample of 86 patients. The results showed that the mortality rate was 32% compared to 57% who died of other causes and zero mortality, thus demonstrating that the proposed protocol resulted effective in decreasing the mortality rate.
The ventilator-associated pneumonia is a nosocomial infection that manifests in intensive care patients with artificial via air, is associated with high morbidity and mortality. Their presence determines a longer stay in intensive care, higher costs, care and increased use of antibiotics. The origin of this infection is polymicrobial and mainly due to Pseudomonas Aeruginosa and Staphylococcus aurous, the forecast depends on the time of onset of symptoms; purulent secretions, high WBC, high temopeartura and radiography with new and persistent infiltrates when he appears before 4 days is early and is produced by germaneness or pharyngeal and mortality is low and is tardy when it appears after 5 days produced by multirresistente very poor prognosis and strains. The main risk factors are age, low birth weight, days of ventilation, poor mobilization among others. The proposed protocol aims to reduce and control these infections in order to prevent propagen in the area and reduce the mortality rate in pediatric patients in that area. This study was conducted in the intensive care unit of the Hospital Pediatric Child Francisco de Icaza Bustamante. This involved 120 patients of both sexes of which worked with a sample of 86 patients. The results showed that the mortality rate was 32% compared to 57% who died of other causes and zero mortality, thus demonstrating that the proposed protocol resulted effective in decreasing the mortality rate.
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Pediatría, Mortalidad, Respiración artificial, Hospital del Niño Francisco de Icaza Bustamante, Cantón Guayaquil, Ecuador, Neumonía