Study on the relationship between ventilator-associated pneumonia and gastroesophageal reflux in surgical intensive care unit

doi:10.3877/cma.j.issn.2095-8765.2020.03.006

Abstract

Abstract:

Objective

Objective to explore the correlation between the concentration of pepsin in pharynx and trachea and the incidence of ventilator-associated pneumonia (VAP) in patients with tracheal intubation in surgical intensive care unit.

Methods

From August 2014 to March 2018, 136 patients with intracerebral hemorrhage who were hospitalized in our intensive care unit (SICU) for more than 48 hours were treated with mechanical ventilation, and their pharyngeal and tracheal secretions were collected at the 48th and 72th hours. Pepsin was detected by enzyme linked immunosorbent assay (ELISA), and their clinical pulmonary infection score (CPIS) was evaluated,to analyze the relationship between pepsin concentration in secretion and CPIs score.

Results

The detection rate of pepsin in pharyngeal cavity and tracheal secretion of 136 patients with endotracheal intubation was 21.32% (29/136) and 47.06% (64/136) at the 48th and 72th hours, respectively. The concentration of pepsin in tracheal secretion of VAP was higher than that of non VAP, and the difference was statistically significant (P＜0.05). There was a correlation between the concentration of pepsin in tracheal secretion of VAP group and CPIs score.

Conclusion

The concentration of pepsin in pharynx and trachea of patients with tracheal intubation in surgical intensive care unit is closely related to the occurrence of VAP, but its specific mechanism needs further study.

Key words: Intensive care unit, mechanical ventilation, ventilator-associated pneumonia, gastroesophageal reflux

Meikelayi·Abudukelimu, Mutalifu·Maihemuti, Daquan. Zhang. Study on the relationship between ventilator-associated pneumonia and gastroesophageal reflux in surgical intensive care unit[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2020, 07(03): 164-166.

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URL: https://zhwsgflbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-8765.2020.03.006

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Figures/Tables 2

一般临床变量	VAP组(n=78)	非VAP组(n=58)	t/χ²	P值
年龄（岁）	45.12±8.99	46.92±9.43	0.126	＞0.05
性别[例（%）]			0.084^*	＞0.05
男	46（58.97）	38（65.52）
女	32(41.03)	20(34.48)
48 h咽腔中胃蛋白酶浓度（ $x ¯$ ±s，ng/ml）	133.88±22.45	105.21±18.34	2.111	＞0.05
48 h气管内胃蛋白酶浓度（ $x ¯$ ±s，ng/ml）	28.89±7.09	13.22±7.11	5.782	＜0.05
72 h咽腔中胃蛋白酶浓度（ $x ¯$ ±s，ng/ml）	172.33±28.34	121.76±23.45	2.445	＞0.05
72 h气管内胃蛋白酶浓度（ $x ¯$ ±s，ng/ml）	37.62±9.32	18.87±6.84	3.511	＜0.05

一般临床变量	VAP组(n=78)	非VAP组(n=58)	t/χ²	P值
年龄（岁）	45.12±8.99	46.92±9.43	0.126	＞0.05
性别[例（%）]			0.084^*	＞0.05
男	46（58.97）	38（65.52）
女	32(41.03)	20(34.48)
48 h咽腔中胃蛋白酶浓度（ $x ¯$ ±s，ng/ml）	133.88±22.45	105.21±18.34	2.111	＞0.05
48 h气管内胃蛋白酶浓度（ $x ¯$ ±s，ng/ml）	28.89±7.09	13.22±7.11	5.782	＜0.05
72 h咽腔中胃蛋白酶浓度（ $x ¯$ ±s，ng/ml）	172.33±28.34	121.76±23.45	2.445	＞0.05
72 h气管内胃蛋白酶浓度（ $x ¯$ ±s，ng/ml）	37.62±9.32	18.87±6.84	3.511	＜0.05

组别	部位	48 h	72 h
VAP组	咽部	0.535*	0.472*
VAP组	气道	0.342*	0.771*
非VAP组	咽部	0.235	0.291
非VAP组	气道	0.179	0.174

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