title: [Ventilator-associated pneumonia in surgical Intensive Care Unit].
abstract: OBJECTIVE
  The ventilator-associated pneumonia (VAP) is a severe infection that presents multiple causes which can vary depending on the type of intensive care unit, type of patients, emphasizing the needs for vigilance measures with local data. The aim of this study is to describe the incidence, risk factors and mortality of VAP in patients in a surgical ICU.
  
  
  METHODS
  Prospective cohort conducted from January 2004 to January 2005. It was included all the patients in mechanical ventilation, followed daily to collect data about demographics, diagnostic, APACHE II and TISS 28 scores, duration of mechanical ventilation, length of stay, incidence of VAP and mortality.
  
  
  RESULTS
  462 patients were studied; age 57.2 ± 16.6 years, 55% men. The mean APACHE II score was 18.3 and the incidence of VAP was 18.8%. The TISS score at admission OR = 1.050 (IC 95%: 1.003-1.050) and the enteral nutrition OR = 5.609 (IC 3.351-9.388) were factors associated with VAP and the prophylactic use of antibiotics was a factor of protection OR = 0.399 (IC95%: 0.177-0.902). The patients with VAP had longer length of stay in ICU (10.3 ± 10.7 vs 4.9 ± 3.3 days), higher median of duration of mechanical ventilation (4 vs 1 days), higher mean of TISS 28 (24.4 ± 4.6 vs 22.8 ± 4.5), and higher crude mortality (46 vs 28.8%) when compared with the patients without VAP.
  
  
  CONCLUSIONS
  VAP was a frequent infection in surgical patients in mechanical ventilation. Enteral nutrition and admission TISS were risk factors and the previous use of antibiotics was protection factor to develop VAP. In our sample the results demonstrate that VAP is associated with higher duration in mechanical ventilation, longer length of stay and higher mortality.
authors.affiliation: UEL.
authors.forename: Claudia Maria Dantas de Maio
authors.initials: CM
authors.lastname: Carrilho
authors.affiliation: UEL.
authors.forename: Cíntia Magalhães Carvalho
authors.initials: CM
authors.lastname: Grion
authors.affiliation: UEL.
authors.forename: Lais Magalhães
authors.initials: LM
authors.lastname: Carvalho
authors.affiliation: Irmandade Santa Casa de Londrina.
authors.forename: Adriana Dos Santos
authors.initials: Ados S
authors.lastname: Grion
authors.affiliation: UEL.
authors.forename: Tiemi
authors.initials: T
authors.lastname: Matsuo