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Korean J Crit Care Med > Volume 25(4); 2010 > Article
Korean Journal of Critical Care Medicine 2010;25(4): 224-229. doi: https://doi.org/10.4266/kjccm.2010.25.4.224
폐 좌상 환자에서의 기계 환기 관련 폐렴에 대한 고찰
가천의대 길병원 응급의학교실, *흉부외과, †성균관대학교 의과대학 삼성창원병원 응급의학교실
VAP (Ventilator-associated Pneumonia) in Patients with Pulmonary Contusion
Jong Hyun Jeong, Sung Youl Hyun, Jin Joo Kim, Jae Hyuk Kim, Yong Su Lim, Jin Seong Cho, Sung Yeon Hwang, Hyuk Jun Yang
1Department of Emergency Medicine, Gachon University Gil Hospital, Incheon, Korea.
2Department of Thoracic & Cardiovascular Surgery, Gachon University Gil Hospital, Incheon, Korea. sungyoul@gilhospital.com
3Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
BACKGROUND: This study was conducted to determine the incidence, risk factors, and outcome of ventilator-associated pneumonia in patients with pulmonary contusion. METHODS: The study was conducted at an urban teaching hospital emergency department with an annual volume of 80,000 patient visits. A retrospective analysis was conducted on thoracic injury patients admitted between Jan 2007 and Dec 2009. Among 122 patients investigated, 30 patients were excluded. Patient data included basal characteristics and information related to development of ventilator-associated pneumonia and ultimate mortality. Statistical methods included the Chi-square test and the Mann-Whitney test. Study data were stored and processed using Microsoft Office Excel 2007 & SPSS 18.0 for Windows. RESULTS: Ventilator-associated pneumonia developed in 46 patients (50%). The patients with ventilator-associated pneumonia were more likely to have a longer duration of hospitalization, longer length of ICU stay, longer duration of mechanical ventilation, a low initial GCS, a higher APACHE II score, and were more likely to require emergency intubation or tracheostomy. Factors associated with mortality included longer duration of hospitalization, longer duration of mechanical ventilation, low intial GCS and the need for dialysis. CONCLUSIONS: Ventilator-associated pneumonia in the patients with pulmonary contusion was not relevant to mortality, but was relevant to longer hospitalization, length of ICU stay and duration of mechanical ventilation.
Key Words: intensive care units; thoracic injury; ventilator-associated pneumonia
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