Case-control analysis and nursing strategy of the risk factors of ventilator associated pneumonia

Objective To analyze the risk factors of ventilator associated pneumonia(VAP),and to provide reference for clinical prevention and treatment of VAP.Methods 864 cases from January 2010 to December 2011 in our hospital with mechanical ventilation time ≥ 48 h were selected,726 cases of non-VAP in same period were selected as control group;risk factors of VAP was analyzed.Results The incidence of VAP was 15.9%.Mechanical ventilation time 5 days,invasive procedure,indwelling gastric tube,the score of APACHE Ⅱ15,disturbance of consciousness,oral care,elevation of the head of the bed and daily sputum excretion were found relate to VAP by single factor analysis.APACHEⅡ score 15,disturbance of consciousness,indwelling gastric tube,mechanical ventilation time 5 days and nerve injury were found to be the independent risk factors for VAP by logistic regression analysis(P 0.01 or P 0.05).The oral care,patient elevated for 30 degrees and daily sputum excretion were found to be the protective factors for VAP.Conclusion Mechanical ventilation has a high incidence of VAP.Reasonable nursing strategies and short mechanical ventilation time can be useful to prevent the occurrence of VAP.