Abstract

VILLAMIL C., ANDREA P.; VARGAS D., ADRIANA  and  OLIVEROS R., HENRY. INCIDENCE OF PNEUMONIA ASSOCIATED WITH MECHANIC VENTILATION IN PATIENTS WITH TRAUMA ADMITTED TO THE INTENSIVE CARE UNIT AT THE HOSPITAL MILITAR CENTRAL. rev.fac.med [online]. 2009, vol.17, n.2, pp.222-230. ISSN 0121-5256.

Pneumonia associated to mechanic ventilation causes 15-20% of the nosocomial infections and produces most of the secondary deaths associated to them. It is estimated that there is an accumulated frequency of this pathology between 2,4 and 14,7 cases for 1.000 days of ventilation in different types of ICU; however there is no data in our setting about the incidence of this type of pneumonia in the patients with trauma. The objective of this work was to determine the incidence of pneumonia associated to mechanic ventilation in the critically traumatized patients, its impact in the morbidity-mortality and the responsible microorganisms. We identified 304 trauma patients admitted to the surgical ICU of the Hospital Military Central requiring mechanical ventilation in the period between January 2001 and August 2008. The incidence of pneumonia associated to mechanic ventilation for every 1000 days of ventilation mechanics was found to be 10 patients, the general risk of pneumonia was 7.8%, the highest risk was after day 16 of mechanic ventilation in 34%. The pneumonia associated to mechanic ventilation was an independent mortality risk factor (OR 2,7). In early-onset pneumonia, the most common pathogen was Pseudomonas aeruginosa in 40% of the cases, and in late-onset polymicrobial pneumonia, the two main isolated organisms were: Staphylococcus aureus in 66% and Pseudomonas aeruginosa in 34%. It was concluded that the rate of pneumonia in the trauma patients is similar in value to patients with other pathologies; however it was found that pneumonia associated to mechanic ventilation is an independent mortality risk factor, increases the hospital stay and the need for invasive supportive ventilation in this type of patient.

Keywords : pneumonia; artificial respiration; Pseudomonas aeruginosa.

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