Does Re-intubation Increased Risk of Ventilator- Associated Pneumonia (VAP) in Pediatric Intensive Care Unit Patients

Introduction:ventilator- associated pneumonia(VAP),as defined by the centers for disease control and prevention (CDC),is a pneumonia that occurs in a patient receiving mechanical ventilation that develops 48 hours or more after initiation of ventilation.re-intubation which occur within 72 hours of planned extubation may effect VAP incidence.the aim of this study was to determine VAP incidence in re-intubated patients in comparision with patients underwent intubation without re-intubation to highlight re-intubation as a risk factor for VAP .Methods and materials: 1230 intubated patients ,admitted to PICU department were enrolled in this cohort observational study consecutively from may 2010 to may 2014.VAP was clinically suggested and confirmed by chest x-ray .patients demographic data,underlying disease,duration of mechanical ventilationlength of picu stayand re-intubations were recorded prospectively. This study was approved by the institute,s ethics committee.Results: 336 intubated patients out of 1230 patients admitted to PICU department developed VAP(27%) with higher incidence in reintubated patients(30% vs 12%).Conclusion: VAP developed in nearly one third of intubated patients in our study.re-intubation was significant risk factor for development of VAP.

Keywords:

Endotracheal intubation , Ventilator associated pneumonia , Re-intubation