Article Text
Abstract
Background and Importance Pneumonia Zero project is a multifactorial national intervention, based on the concurrent application of measures to prevent ventilator-associated pneumonia (VAP). Within the package of measures, selective digestive decontamination (SDD) is included as an optional but highly recommended measure.
Aim and Objectives SDD was recently implemented in our centre with a paste and solution formulation based on colistin, tobramycin and nystatin. Our aim is analysing incidence and mortality of VAP after SDD implantation and related factors.
Material and Methods Retrospective observational study in second-level hospital including all patients who consumed DDS formula in Intensive Care Unit (ICU) during 2022. Data were collected from digital medical records and FarmaTools® electronic prescription software: age, sex, cause of admission to ICU (medical, surgical or trauma), days of ICU stay, days with mechanical ventilation (MV), presence or absence of VAP during admission, use of intravenous antibiotics during MV, presence or absence of multidrug-resistant microorganism in cultures and deaths.
For data analysis, we calculated incidence of VAP, median days with MV in patients with VAP, multidrug-resistant organisms in patients with VAP, incidence of deaths in patients with and without VAP.
Sample 71 patients (73% male). Median age: 61 [17–85]. Cause of ICU admission; medical: 61 (81%), surgical: 6 (8%), trauma: 4 (7%). Median number of days in ICU: 14 [1–82]. Median days with MV: 10 [1–75]. Patients with VAP: 18 (25%). Use of antibiotics during MV: 57 (80%). Multidrug-resistant microorganisms: 10 (14%). Deaths: 41 (57%)
VAP incidence 25%. Median days of MV in VAP patients: 14 [4–63]. Multidrug-resistant microorganisms in VAP: 9 (50%). Death incidence without VAP: 18%. Death incidence with VAP: 44%.
Conclusion and Relevance Data suggest a significant incidence of VAP and a higher associated mortality compared who have not suffered this complication during admission. As would be expected the incidence increases with the number of days on MV. Most cases, intravenous antibiotics were used as a measure included in the Zero Pneumonia protocol. It should be noted that half of the micro-organisms isolated in patients with VAP are multi-resistant. More data from previous years prior to the introduction of SDD would be needed to compare a real-world effectiveness
Conflict of Interest No conflict of interest.