摘要
Background:Ventilator-associated pneumonia (VAP) in neonates has been associated with high mortality and poor outcome.This study aimed to compare the incidence,risk factors,and outcomes of VAP and nonVAP conditions in neonates.Methods:We performed a prospective cohort study in a neonatal intensive care unit (NICU) in Thailand from January 2014 to December 2014.All neonatal patients who were ventilated more than 48 hours were enrolled.Results:There were 128 enrolled patients.The median (inter quartile range) gestational age and birthweight were 35 (30.2,37.8) weeks and 2380 (1323.8,3020.0) g.There were 17 VAP patients (19 episodes) and 111 non-VAP ones.The VAP rate was 13.3% or 10.1 per 1000 ventilator days.According to the multivariate analysis,a birthweight less than 750 g [adjusted odds ratio (aOR)=10.75,95% confidence interval (CI)=2.35-49.16;P=0.002] and sedative medication use (aOR=4.00,95% CI=1.23-12.50;P=0.021)were independent risk factors for VAP.Compared with the non-VAP group,the median difference in the VAP group yielded a significantly longer duration of NICU stay (18 days,P=0.001),total length of hospital stay (16 days,P=0.002) and higher hospital costs ($5113,P=0.001).The inhospital mortality rate in the VAP and non-VAP groups was 17.6% and 15.3% (P=0.73),respectively.Conclusions:A neonatal birthweight less than 750 g and sedative medication use were independent risk factors for VAP.Our VAP patients experienced a longer duration of both NICU and hospital stay,and incurred higher hospitalization costs.
作者简介
Corresponding Author:Anucha Thatrimontrichai,MD,DiVision of Neonatology,Depanment of Pediatrics,Faculty of Medicine,Prince of Songkla UniVersity,Hat Yai,Songkhla 90l 10,Thailand(T el:66 7445 1257;Fax:66 7442 9618;Email:anuchanicu@hotmail.com)
