Ventilator-Associated Pneumonia in Neurosurgical Patients: A Tertiary Care Center Study

  • Dipendra K Shrestha
  • Binod Rajbhandari
  • Amit Pradhanang
  • Gopal Sedain
  • Sushil K Shilpakar
  • Saurav Pradhan

Abstract

Introduction
Ventilator-associated pneumonia (VAP) is a well recognized complication in patients who are admitted to the
Intensive Care Unit (ICU). A number of factors have been suspected or identified to increase the risk of VAP in
Neurosurgical patients. Early and rapid diagnosis and initiation of the appropriate antibiotic treatment reduce
mortality and decrease the development of MDR organisms. The aim of our study is to determine the incidence
of VAP in the neurosurgical patients and also to assess the probable contributing neurosurgical risk factors and
find out the causative bacterial pathogens and the resistant pattern of these bacteria in neurosurgical patient in
ICU of our institute
Methods
A retrospective observational study of 106 neurosurgical patients who were on mechanical ventilation for more
than 48 hours was done.
Results
Out of 106 patients, 35 patients fulfilled the clinical and microbiological criteria for the diagnosis of VAP. The
commonest age group involved was between 15-25 years of age with male preponderance. Head injury was the
commonest etiology. There was a linear correlation between the number of days in ICU and the development of
VAP. The majority of the pathogen isolated were gram-negative bacteria and all were sensitive to Colistin.
Conclusion
Head injury is a significant risk factor for VAP. Prolonged mechanical ventilation is an important risk factor for
VAP.
Keywords
Intensive care unit, neurosurgical patient, ventilator-associated pneumonia

Published
2019-08-26