[Ventilator associated pneumonia in a neonatal intensive care unit].
BACKGROUND
The studies that describe risk factors for the development of ventilator-associated pneumonia (VAP) in newborn infants report dissimilar information, possibly related to the type of intensive care unit and population included. The objective of this study was to identify risk factors for the development of VAP in a neonatal intensive-care unit.


METHODS
Case-control study. Patients with the diagnosis of VAP were classified as cases and compared with two controls of the same gestational age, weight, and diagnosis at admission. We analysed the data using descriptive and inferential statistics: chi-squared test, Student's t-test, odds-ratio, 95 % confidence interval and logistic regression analysis.


RESULTS
A total of 45 cases and 90 controls were analysed. The risk factors statistically significant in the univariate analysis were: previous episode of sepsis, reintubation, airway malformation, exclusive parenteral nutrition, and days of mechanical ventilation. In the logistic regression analysis we obtained these data: reintubation (OR 41.26, CI 95 % 11.9-158.4, p = 0.001), airway malformation (OR 19.5, CI 95 % 1.34-282.3, p = 0.029), and days of mechanical ventilation (OR 8.9, CI 95 % 1.9-40.8, p = 0.005). These were the only risk factors independently associated to VAP.


CONCLUSIONS
Of the significant risk factors, it is possible to intervene in reintubation events, by securing the endotracheal cannula with an adequate fixation, mobilize the patient ensuring safety, and follow a decannulation protocol to reduce ventilation days.
Departamento de Infectología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Distrito Federal, México. guadalumiranda@terra.com.mx.
Dassaev
D
Izelo-Flores
Fortino
F
Solórzano-Santos
María Guadalupe
MG
Miranda-Novales
D016022:Case-Control Studies; D003428:Cross Infection / Q000209:etiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000209:etiology*; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D013997:Time Factors
Neonatal intensive care units; Newborn infant; Nosocomial infections; Ventilator-associated pneumonia