Exploring Risk Factors with Ventilator Associated Pneumonia among Infants in Intensive Care Units

Abstract
Background: Ventilator Associated Pneumonia (VAP) is defined as pneumonia occurring more than 48 hours after child is intubated and ventilated mechanically; VAP is the second most common hospital-acquired infection in pediatric Intensive Care Units, which linked to increased morbidity, mortality, lengths of stay in the hospital and intensive care unit with high costs.
Aim of Study: The current study aimed to explore the risk factors of VAP among infants in Intensive Care Units.
Subjects and Methods: A descriptive exploratory design was used to achieve the current study.
Setting: The current study conducted at Pediatric Intensive Care Units at Pediatric University Hospital and Specialized Pediatric Hospital which affiliated to Cairo University Hos-pitals.
Sample: A convenience sample of 54 mechanically ven-tilated infants for more than 48 hours enrolled in the study.
Tools: The required data was collected by using risk factors assessment sheet and standardized observational checklists which consist of three parts: General infection control measures, nasogastric tube feeding and endotracheal tube suctioning.
Results: The current study results revealed that, more than half of infants were less than 6 months of age, nearly two-thirds are males, and near to three quarters of infants developed VAP. Prior antibiotic use, sedatives administration, absence of routine oral care, previous non-invasive ventilation, reintubation, length of stay on mechanical ventilation and PICUs, coma, inadequate general infection control measures, inadequate endotracheal tube suctioning technique, supine position, inadequate nasogastric tube feeding technique, presence of nasogastric tube and oral route of endotracheal tube were statistically significant risk factors associated with VAP. More than half of VAP infants died during period of hospitalization.
Conclusion: Prior antibiotic use was the only independent risk factor for incidence of VAP; and sedatives administration, absence of routine oral care, previous non-invasive ventilation, reintubation, length of stay on mechanical ventilation and PICUs were the major risk factors of VAP among infants in pediatric Intensive Care Units.
Recommendations: Inservice training program should be conducted for pediatric intensive care nurses about prevention of VAP among infants. Also, similar studies should be con-ducted on large sample and different settings.