“NEUMONÍA ASOCIADA A VENTILACIÓN MECÁNICA (NAV) EN PACIENTES CON TRAUMATISMO CRANEOENCEFÁLICO (TCE) SEVERO, EN LA UNIDAD DE CUIDADOS INTENSIVOS DEL HOSPITAL TEODORO MALDONADO CARBO EN EL AÑO 2016”

Abstract

Background: Ventilator - associated pneumonia (VAP) due to mechanical ventilation (MV) has been reported as being more frequent among patients with Severe Trauma Brain Injury (TBI), due to factors that imply a physiopathological process with multifactorial effects that affect a "route". in between the brain and the lung, facilitating the development of this complication. However, certain factors increase the risk of developing it, although there are discrepancies about the role of some of them. Objective: To determine the risk factors of developing VAP among patients with severe TBI. Methodology: A relational, case – control study design was carried out in which patients with severe TBI treated in the Intensive Care Unit (ICU) of the Teodoro Maldonado Carbo Hospital (HTMC) in 2016 were included: 26 consecutive cases with severe TBI that developed VAP and 78 controls randomly chosen. Results: The prevalence of VAP among patients with severe TBI was 14.2%, mortality 26.9%: Associations were identified with factors such as severe Glasgow score (P 0.000032, OR 7.4, 95% CI 2.8-19 , 6), car accident (P 0.000137, OR 6.1, IC95% 2.2-16.3), Comorbidity (P 0.039, OR 3.8, IC95% 1.0-13.9), and multi-resistant germ infection (P 0.000044; OR 8.5, IC95% 2.9 - 24.0). The need for tracheostomy (P 0.016, OR 0.2, 95% CI 0.1-0.6), early tracheostomy (P 0.016, OR 0.1, IC95% 0.03-0.6) were identified as protection factors Conclusion: The presence of risk factors increases the possibility of developing VAP among patients with severe TBI in the HTMC.