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Hospital-acquired pneumonia (HAP) in patients in intensive care often requires the mechanical ventilation (MV). Management and weaning from MV are given by specificity of this type of pulmonary inflammation. Enrolled in the retrospective, observational study were all patients older than 18 years staying at the ICU of University Hospital in Olomouc, between 1 January 2011 and 31 December 2016. The determination of the parameters of the MV, ICU length of stay, hospital length of stay and mortality in HAP group were compared with the control group of patients without HAP.
Hospital-acquired pneumonia (HAP) development influences the parameters of mechanical ventilation, intensive care unit (ICU) length of stay, hospital length of stay, need of tracheostomy, bronchoscopy, reconnection to MV and mortality. We respect HAP definition: acute inflammation of the respiratory bronchioles, alveolar structures and pulmonary interstitium. Clinically it is defined as the presence of newly developed or progressive infiltrates on chest radiographs plus at least two other signs of respiratory tract infection: temperature >38 °C, chest pain, purulent sputum, leukocytosis or leukopenia, signs of inflammation on auscultation, cough and/or respiratory insufficiency. HAP is defined as pneumonia that occurs 48 hours or more after admission, which was not incubating at the time of admission. A retrospective, observational study processing data on all consecutive intensive care patients older than 18 years of age between 1 January 2011 and 31 December 2015. The aim was to determine the incidence of potential risk factors and their impact on the development of HAP. The primary outcome was investigation of the relationship between mechanical ventilation parameters and the presence of early- and late-onset HAP. Enrolled in the study were patients staying at the ICU of the Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, between 1 January 2011 and 31 December 2016. The participants were all patients older than 18 years of age consecutively admitted to the ICU.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HAP patients | Mechanical ventilation, patients fulfilled HAP criteria |
| |
| non HAP patients | Mechanical ventilation, patients without HAP |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| mechanical ventilation | Device | Connection to mechanical ventilator |
|
| Measure | Description | Time Frame |
|---|---|---|
| length of mechanical ventilation | days of MV | during MV |
| Measure | Description | Time Frame |
|---|---|---|
| ICU length of stay | length of stay in ICU | 1 month |
| Hospital length of stay (LOS) | length of hospital stay | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Inspiratory pressure | most high inspiratory pressure during MV | during MV |
| Positive end expiratory pressure (PEEP) | most high PEEP during MV |
Inclusion Criteria:
Exclusion Criteria:
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Enrolled in the study were patients staying at the ICU of the Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, between 1 January 2011 and 31 December 2015. The participants were all patients older than 18 years of age consecutively admitted to the ICU, who met HAP criteria.
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| Name | Affiliation | Role |
|---|---|---|
| Radovan Uvizl | UH Olomouc | Principal Investigator |
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| ID | Term |
|---|---|
| D012121 | Respiration, Artificial |
| ID | Term |
|---|---|
| D058109 | Airway Management |
| D013812 | Therapeutics |
| D012151 | Resuscitation |
| D004638 | Emergency Treatment |
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| Mortality | mortality during Hospital LOS | 1 month |
| during MV |
| D012138 |
| Respiratory Therapy |