NEUMONÍA ASOCIADA A VENTILACIÓN MECÁNICA Y RELACIÒN CON ANTIBIÓTICOS NEBULIZADOS

Abstract

BACKGROUND: Ventilator-associated pneumonia (VAP) is the type of nosocomial pneumonia manifested in intubated patients 48 hours after endotracheal intubation and mechanical ventilation. VAP is the most frequent complication in patients admitted to the ICU, increasing morbidity and mortality and multiorgan failure (FMO) (1). Objectives: The main objective was to demonstrate that patients with mechanical ventilation and who used antibiotic nebulization, the incidence of VAPD decreased compared to those who were not nebulized with antibiotics. Methodology: An observational, descriptive and prospective study was carried out in the critical areas of the Teodoro Maldonado Carbo Hospital, where 112 patients were included from May to December 2016, intubated for less than 48 hours and without previous pulmonary pathology; We proceeded to take culture sample of tracheal aspirate and the application of amikacin (antibiotic) nebulized. For such data collection, the electronic sheet of Microsoft Excel 2013 was applied, and variables such as: age, sex, comorbidities, diagnoses, antibiotic misting and days of mechanical ventilation were used. Results: Of the 112 patients, 50% were men and 50% women, with a age range of 26-35 years in 24% (N = 27). We classified 2 groups of which 42 patients received nebulized antibiotic therapy as coadjuvant therapy and 70 patients did not receive it; With a reduction in the rate of development of VAP in 67% (N = 28). However, the days of mechanical ventilation were not relevant for both groups; As well as comorbidities and the diagnosis of admission; In the latter the postoperative patients of both groups developed NAVM; Attributed to the permanence of mechanical ventilation and to the multiple interventions that it required. xi Conclusions: It was concluded, like other studies, that nebulized antibiotic treatment is useful as an adjuvant therapy in patients with MRSA by multiresistant bacteria that do not respond to treatment; Also directed to patients with cystic fibrosis (CF) and bronchiectasis without CF.