- 期刊
The Incidence of Ventilator-Associated Pneumonia in Weekly and Bi-Weekly Ventilator Circuit Changes
呼吸器換管頻率與呼吸器相關性肺炎發生率之研究
摘要
背景：接受呼吸器治療的患者會併發呼吸器相關肺炎的可能，國內外醫院研究發現過度頻繁的呼吸器管路更換甚至可能增加肺炎的發生率，本研究目的探討呼吸器管路每週二次延長為每週一次對於肺炎發生率的影響。 方法：本院內科加護病房、呼吸加護病房及普通病房接受呼吸器的成人患者（十五歲以上），依兩年的追蹤比照研究，研究組340位患者在2000年一月至六月間接受呼吸器管路每週一換；對照組內210個患者在1999年一月至六月間接受呼吸器管路每週兩換。計算兩組呼吸器相關性肺炎的發生率。肺炎診斷依據美國疾病管制中心所建議的條件。 結果：對照組總計在3,372呼吸器使用日中有20次肺炎發生，發生率每千人日5.93次。研究組在5,035呼吸器使用日中有20次肺炎發生發生率為每千人日3.97次。兩組肺炎發生率統計上並無顯著差別。 結論：延長呼吸器換管頻率從每週二次至每週一次並不影響肺炎發生率。
並列摘要
Background: Patients undergoing mechanical ventilation are exposed to the risk of ventilator-associated pneumonia (VAP). Frequent ventilator circuit changes are expensive and unnecessary. We investigated whether extending ventilator circuit intervals from twice weekly to once weekly would impact VAP rates at our hospital. Methods: Prospective 2-year review of mechanically ventilated adult patients in the medical ICU, respiratory ICU, and general ward at Changhua Christian Hospital. The patients whose ventilator circuits were changed twice a week (at 3- or 4-days intervals) from January 1999 to June 1999 comprised the control group; those whose ventilator circuits were changed once a week from January 2000 to June 2000 formed the study group. There were 210 patients in the control group and 340 patients in the study group receiving mechanical ventilation. Ventilator-related pneumonia was diagnosed based on the criteria of the United States Centers for Disease Control (CDC). The incidence of VAP was determined in both groups. Results: In the control group, 20 patients developed VAP within 3,372 ventilator days, resulting in a rate of 5.93 per 1000 ventilator days. In the study group, 20 cases of VAP in 5,035 ventilator days resulted in a pneumonia rate of 3.97 per 1000 ventilator days. The difference between the groups was not statistically significant (relative risk 1.51; 95% confidence interval 0.81-2.80; p=0.196). Conclusions: Extending the intervals between ventilator circuit changes from twice a week to once a week does not increase the risk for VAP.