Effect of Gastrointestinal Function on Ventilator-associated Pneumonia in Critically Ill Patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZhangHongwei ¹ ,  WeiLiyou ² , LiuShuzheng ¹ , YangYajing ³ , ZhangJing ⁴ , ZhangZhenyu ⁴

1. Intensive Care Unit,The Second Hospital of Tangshan,Tangshan,Hebei,063000,China;
2. ;
3. ;
4. ;

Corresponding author：

WeiLiyou, Email: weiliyou888@163.com

Keywords：

Critically ill patients; Gastrointestinal function; Ventilator-associated pneumonia; Mechanical ventilation

DOI：

10.7507/1671-6205.2016032

Video：

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Objective To investigate the relationship between the gastrointestinal function and ventilator-associated pneumonia (VAP) in critically ill patients who underwent invasive mechanical ventilation. Methods One-hundred and fifty-three cases of critically ill patients receiving mechanically ventilation were recruited in the study. After 5 days of ventilation, the gastrointestinal function score and the C-reactive protein (CRP) of each patient were recorded. The incidence of VAP was recorded during hospitalization. According to the incidence of VAP, all patients were divided intoaVAP group and a non-VAP group. The relationship between gastrointestinal function score and the incidence of VAP was analyzed. The relationship between CRP level and severity degree of VAP was also analyzed. Results VAP occurred in 42 cases with the incidence of 27.45%. The gastrointestinal function score (1.9±1.0 vs. 0.8±1.0, P < 0.05) and CRP level [(52.38±12.06) mg/L vs. (36.69±11.08)mg/L, P < 0.05] were both higher in the VAP group than those in the non-VAP group. At gastrointestinal function score of 0 - 3, the CRP levels were all higher in the VAP group than those in the non-VAP group (P < 0.05). The incidence of VAP was 8.33%, 23.68%, 45.45%, and 59.09% at gastrointestinal function score of 0, 1, 2 and 3, respectively, with significant differences between each other(P < 0.05). Conclusion For critically ill patients receiving invasive mechanical ventilation, the more severe the damage of gastrointestinal function is, the higher the incidence of VAP is, and the more serious the disease is.

Citation： ZhangHongwei, WeiLiyou, LiuShuzheng, YangYajing, ZhangJing, ZhangZhenyu. Effect of Gastrointestinal Function on Ventilator-associated Pneumonia in Critically Ill Patients. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(2): 133-135. doi: 10.7507/1671-6205.2016032 Copy

1.	刘庆华, 何礼贤.胃肠道和呼吸机相关性肺炎.中国呼吸与危重监护杂志, 2003, 2: 317-318.
2.	张敏, 叶小玲, 晋金兰.呼吸机相关性肺炎预后与简化临床肺部感染评分动态变化的相关性研究.中国呼吸与危重监护杂志, 2014, 13: 378-380.
3.	张宏伟, 刘淑正, 张振宇, 等.振动排痰机在治疗重症监护病房呼吸机相关性肺炎中的作用.中华物理医学与康复杂志, 2015, 37: 45-47.
4.	张宏伟, 魏立友, 刘淑正, 等.保持呼吸机管路低位对预防呼吸机相关性肺炎的作用.中华急诊医学杂志, 2015, 24: 68-71.
5.	王今达, 王宝恩.MODS病情分期诊断及严重程度评分标准.中国危重病急救医学, 1995, 7: 346-347.
6.	张宏伟, 魏立友, 张振宇, 等.ICU患者早期集束化气道干预对预防呼吸机相关性肺炎的作用.中国综合临床, 2014, 30:383-386.
7.	张宏伟, 魏立友, 张振宇, 等.非床头抬高干预策略对预防呼吸机相关性肺炎的作用.中国急救医学, 2014, 34:347-350.
8.	代芊, 邓宏, 黄汉朝, 等.随机扩增多态性技术在院内肺炎逆行感染途径研究中的应用.中华医院感染学杂志, 2001, 11: 75-77.
9.	Rello J, Ollendorf DA, Oster G, et al. Epidemiology and outcomes of ventilator associated pneumonia in a large US database.Chest, 2002, 122: 2115-2121.
10.	Rombeau JL, Takala J.Summary of round table conference: gut dysfunction in critical illness.Intensive Care Med, 1997, 23:476-479.
11.	Zhang H, Wei L, Zhang Z, et al.Protective effect of periplaneta americana extract on the intestinal mucosal barrier function in patients with sepsis. J Tradit Chin Med, 2013, 33: 70-73.
12.	MaeCallum NS, Evans TW.Epidemiology of acute lung injury.Curr Opin Crit Care, 2005, 11: 43-49.
13.	Sierra R, Rello J, Bailén MA, et al.C-reactive protein used as an early indicator of infection in patients with systemic inflammatory response syndrome.Intensive Care Med, 2004, 30: 2038-2045.
14.	许榕椿, 王梅华.危重病患者C-反应蛋白与APACHEⅢ评分相关性的回顾性分析.山西医科大学学报, 2009, 40: 1117-1118.
15.	王彦, 张淑文, 王超, 等.多器官功能障碍综合征患者呼吸机相关性肺炎的危险因素分析.中华急诊医学杂志, 2006, 15: 1010-1013.
16.	Diaz O, Diaz E, Rello J.Risk factors for pneumonia in the intubated patients. Infect Dis Clin North Am, 2003, 17: 697-705.

1. 刘庆华, 何礼贤.胃肠道和呼吸机相关性肺炎.中国呼吸与危重监护杂志, 2003, 2: 317-318.
2. 张敏, 叶小玲, 晋金兰.呼吸机相关性肺炎预后与简化临床肺部感染评分动态变化的相关性研究.中国呼吸与危重监护杂志, 2014, 13: 378-380.
3. 张宏伟, 刘淑正, 张振宇, 等.振动排痰机在治疗重症监护病房呼吸机相关性肺炎中的作用.中华物理医学与康复杂志, 2015, 37: 45-47.
4. 张宏伟, 魏立友, 刘淑正, 等.保持呼吸机管路低位对预防呼吸机相关性肺炎的作用.中华急诊医学杂志, 2015, 24: 68-71.
5. 王今达, 王宝恩.MODS病情分期诊断及严重程度评分标准.中国危重病急救医学, 1995, 7: 346-347.
6. 张宏伟, 魏立友, 张振宇, 等.ICU患者早期集束化气道干预对预防呼吸机相关性肺炎的作用.中国综合临床, 2014, 30:383-386.
7. 张宏伟, 魏立友, 张振宇, 等.非床头抬高干预策略对预防呼吸机相关性肺炎的作用.中国急救医学, 2014, 34:347-350.
8. 代芊, 邓宏, 黄汉朝, 等.随机扩增多态性技术在院内肺炎逆行感染途径研究中的应用.中华医院感染学杂志, 2001, 11: 75-77.
9. Rello J, Ollendorf DA, Oster G, et al. Epidemiology and outcomes of ventilator associated pneumonia in a large US database.Chest, 2002, 122: 2115-2121.
10. Rombeau JL, Takala J.Summary of round table conference: gut dysfunction in critical illness.Intensive Care Med, 1997, 23:476-479.
11. Zhang H, Wei L, Zhang Z, et al.Protective effect of periplaneta americana extract on the intestinal mucosal barrier function in patients with sepsis. J Tradit Chin Med, 2013, 33: 70-73.
12. MaeCallum NS, Evans TW.Epidemiology of acute lung injury.Curr Opin Crit Care, 2005, 11: 43-49.
13. Sierra R, Rello J, Bailén MA, et al.C-reactive protein used as an early indicator of infection in patients with systemic inflammatory response syndrome.Intensive Care Med, 2004, 30: 2038-2045.
14. 许榕椿, 王梅华.危重病患者C-反应蛋白与APACHEⅢ评分相关性的回顾性分析.山西医科大学学报, 2009, 40: 1117-1118.
15. 王彦, 张淑文, 王超, 等.多器官功能障碍综合征患者呼吸机相关性肺炎的危险因素分析.中华急诊医学杂志, 2006, 15: 1010-1013.
16. Diaz O, Diaz E, Rello J.Risk factors for pneumonia in the intubated patients. Infect Dis Clin North Am, 2003, 17: 697-705.

Chinese Journal of Respiratory and Critical Care Medicine

Effect of Gastrointestinal Function on Ventilator-associated Pneumonia in Critically Ill Patients

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