Articles Vol. 65 No. CĐ 9 - Hội Gây mê Hồi sức 26/09/2024

5. EVALUATION OF COMPLIANCE WITH VENTILATOR-ASSOCIATED PNEUMONIA PREVENTIVE BUNDLES AT THE CENTER FOR ANESTHESIA AND SURGICAL INTENSIVE CARE IN BACH MAI HOSPITAL

Vu Van Kham1,2, Ho Sỹ Hai1,2, Le Huu A1,2, Nguyen Toan Thang1,2,3,4
1 Bach Mai Hospital
2 Bệnh viện Bạch Mai
3 Hanoi Medical University
4 Trường Đại học Y Hà Nội
Corresponding author: nguyentoanthang@hmu.edu.vn
DOI: 10.52163/yhc.v65iCD9.1510
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Keywords
Ventilator-associated pneumonia preventive bundle compliance resuscitation unit
Abstract

Background: Ventilator-associated pneumonia (VAP) is a common complication in mechanically ventilated patients in intensive care units. A VAP preventive bundle developed by the National Center for Global Health and Medicine of the Ministry of Health, Japan consisting of 10 measures has been transferred and applied at Bach Mai Hospital. The study was conducted to evaluate the level of compliance with the preventive bundle and the incidence of VAP.

Research methods: A prospective observational study was conducted at Center for Anesthesia and Surgical Intensive Care, Bach Mai Hospital from December 2023 to June 2024, to monitor compliance with VAP preventive bundle. The study included all patients ≥ 18 years old, mechanically ventilated after surgery, and without previous pneumonia, and excluded those who were mechanically ventilated for less than 48 hours. The incidences of compliance with measures and prevalence of VAP were monitored and recorded.

Results: There were 337 patients who met the study criteria. The incidence of VAP in the patient group was 25.2% (frequency 36.5 cases/1000 ventilator days). The overall compliance rate of the VAP preventive bundle was 66.5%. Compliance rates > 80% were achieved for hand hygiene, head elevation 30-45 degrees, oral hygiene, breathing circuit management and cuff pressure management, and gastric ulcer and deep vein thrombosis prevention. The compliance rates for sedation management, use of hypoplastic suction, daily spontaneous breathing trial and weaning, and early bed leaving were below 50%.

Conclusion: The overall compliance rate of the VAP preventive bundle was 66.5%. The incidence rate of VAP in the study was 25.2%.

References
[1]
Ding C, Zhang Y, Yang Z, Wang J, Jin A, Wang W, Chen R, Zhan S, Incidence, temporal trend and factors associated with ventilator- associated pneumonia in mainland China: a systematic review and meta-analysis, BMC infectious diseases, 2017, 17(1), 468, https://doi.org/10.1186/s12879-017-2566-7 Google Scholar
[2]
Rosenthal VD, Jin Z, Memish ZA, Rodrigues C, Myatra SN, Kharbanda M, Valderrama-Beltran, SL, Mehta Y, Daboor MA, Todi SK, Aguirre-Avalos G, Guclu E, Gan CS, Jiménez Alvarez LF, Chawla R, Hlinkova S, Arjun R, Agha HM, Zuniga Chavarria MA, Davaadagva N, Yin R, Multinational prospective cohort study of rates and risk factors for ventilator-associated pneumonia over 24 years in 42 countries of Asia, Google Scholar
[3]
Africa, Eastern Europe, Latin America, and the Middle East: Findings of the International Nosocomial Infection Control Consortium (INICC), Google Scholar
[4]
Antimicrobial stewardship & healthcare epidemiology: ASHE, 2023, 3(1), e6. https://doi.org/10.1017/ash.2022.339 Google Scholar
[5]
Battaglini D, Parodi L, Cinotti R, Asehnoune K, Taccone FS, Orengo G, Zona G, Uccelli A, Ferro G, Robba M, Pelosi P, Robba C, Ventilator-associated pneumonia in neurocritically ill patients: insights from the ENIO international prospective observational study, Respiratory research, 2023, Google Scholar
[6]
(1), 146. https://doi.org/10.1186/s12931-023-02456-9 Google Scholar
[7]
Battaglini D, Parodi L, Cinotti R, Asehnoune K, Taccone FS, Orengo G, Zona G, Uccelli A, Ferro G, Robba M, Pelosi P, Robba C, Ventilator-associated pneumonia in neurocritically ill patients: insights from the ENIO international prospective observational study, Respiratory research, 2023, 24(1), 146. https://doi.org/10.1186/s12931-023-02456-9 Google Scholar
[8]
Bird D, Zambuto A, O'Donnell C, Silva J, Korn C, Burke R, Burke P, Agarwal S, Adherence to ventilator-associated pneumonia bundle and Google Scholar
[9]
incidence of ventilator-associated pneumonia in the surgical intensive care unit, Archives of surgery (Chicago, Ill: 1960), 2010, 145(5), 465-470. https://doi.org/10.1001/archsurg.2010.69 Google Scholar
[10]
Sekihara K, Okamoto T, Shibasaki T, Matsuda W, Funai K, Yonehiro Y, Matsubara C, Kimura A, Evaluation of a bundle approach for the prophylaxis of ventilator-associated pneumonia: A retrospective single-center Study, Global health & medicine, 2023, 5(1), 33-39. https://doi.org/10.35772/ghm.2022.01038 Google Scholar
[11]
Hoang HM, Dao CX, Huy Ngo H, Okamoto T, Matsubara C, Do SN, Bui GT, Bui HQ, Duong NT, Nguyen NT, Vuong TX, Van Vu K, Phạm TT, Van Bui C, Efficacy of compliance with ventilator-associated pneumonia care bundle: A 24-month longitudinal study at Bach Mai Hospital, Vietnam, SAGE open medicine, 2024, 12, 20503121231223467. https://doi.org/10.1177/20503121231223467 Google Scholar
[12]
Nguyễn Gia Bình, Ngô Quý Châu và cs, Khuyến cáo chẩn đoán và điều trị viêm phổi bệnh viên và viêm phổi liên quan thở máy, Hội Hô hấp Việt Nam và Hội Hồi sức cấp cứu - Chống độc Việt Nam, 2023. Google Scholar
[13]
Klompas M, Branson R, Cawcutt K et al, Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 Update, Infect Control Hosp Epidemiol, 2022, 43(6): 687-713. https://doi.org/10.1017/ice.2022.88 Google Scholar
[14]
Mastrogianni M, Katsoulas T, Galanis P, Korompeli A, Myrianthefs P, The Impact of Care Bundles on Ventilator-Associated Pneumonia Google Scholar
[15]
(VAP) Prevention in Adult ICUs: A Systematic Review, Antibiotics (Basel, Switzerland), 2023, 12(2), 227, https://doi.org/10.3390/antibiotics12020227. Google Scholar