Ventilator Associated Pneumonia In Neonatal Intensive Care Units

Öz

Ventilator-associated pneumonia VAP is the second most common nosocomial infection in the neonatal intensive care units NİCU which, is a serious complications of mechanical ventilation. The duration of hospitalization and mortality rate may increase due to VAP in the NİCU. The diagnosis is confirmed by the evaluation of clinical and radiological findings. It’s difficult to obtain non-contaminated samples of the lower respiratory airway and microbiological examination during the neonatal period. Therefore, antibiotic therapy is often given empirically. Recently, the culture and microscopic examination of the sample obtained by blind or non-bronchoscopic bronchoalveolar lavage for the diagnosis of VAP shown to have high sensitivity and specificity. These techniques are applicable in the neonatal period. Ventilator-associated pneumonia is a preventable hospital-acquired infections. The collection of applications in a package to reduce the rate of ventilator-associated pneumonia and full implementation of these applications are called as bundle approach. Bundle approach achieved a significant reduction in the VAP rate. This review aimed to provide current information about the prevalence, pathogenesis and the treatment of neonatal VAP and to remind what can be done to prevent VAP.

Anahtar Kelimeler

• Ventilator-associated pneumonia,new born,prevention

Yenidoğan Yoğun Bakım Ünitelerinde Ventilatör İlişkili Pnömoni

Öz

Mekanik ventilasyonun önemli bir kompilikasyonu olan ventilatör ilişkili pnömoni VİP yenidoğan yoğun bakım ünitelerinde YYBÜ ikinci en sık görülen hastane kaynaklı enfeksiyondur. Yoğun bakımda yatış süresini ve mortaliteyi artırabilir. Tanı, klinik ve radyolojik bulguların değerlendirilmesiyle konur. Yenidoğan döneminde alt hava yollarından kontamine olmamış örneklerin alınması ve mikrobiyolojik incelemelerin yapılması zordur. Bu nedenle antibiyotik tedavisi sıklıkla ampirik olarak başlanır. Son yıllarda non-bronkoskopik ya da kör bronkoalveoler lavaj gibi tekniklerle alınan örneklerin kültür ve mikroskobik incelemelerinin yenidoğan VİP tanısında duyarlılık ve hassasiyettinin yüksek olduğu gösterilmiştir. Bu teknikler yenidoğan döneminde de uygulanabilir Ventilatör ilişkili pnömoni önlenebilir bir hastane kaynaklı enfeksiyondur. Ventilatör ilişkili pnömoni hızını azaltmaya yönelik uygulamaların bir paket içinde toplanması ve eksiksiz uygulanması “bundle” yaklaşımı olarak adlandırılır. “Bundle” uygulaması ile VİP hızında anlamlı bir azalma sağlanabilir. Bu derleme, neonatal VİP’in yaygınlığı, patogenezi ve tedavisi konusunda güncel bilgiler sunmayı ve VİP’i önlemeye yönelik yapılabilecekleri hatırlatmayı amaçlamaktadır.

Anahtar Kelimeler

• Ventilatör ilişkili pnömoni,yenidoğan,önleme

Kaynakça

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