Resumo

MACIQUES RODRIGUEZ, Raquel; CASTRO PACHECO, Berta L.; MACHADO SIGLER, Omar  e  MANRESA GOMEZ, Dania. Neumonía nosocomial asociada a ventilación mecánica. Rev Cubana Pediatr [online]. 2002, vol.74, n.3, pp. 222-232. ISSN 1561-3119.

It is reported that pneumonia associated with mechanical ventilation is a particular type of nosocomial infection that is frequently found among critical patients and it is related to high morbidity and mortality rates. Its origin is polymicrobial and depends on multiple risk factors, such as: age, days of ventilation, little mobilization, gastric alcanilization, trauma, coma and use of drugs as sedatives and blockading agents, among others. The fundamental strategies to prevent this disease are aimed at reducing the impact of the intrinsic or extrinsic risk factors. Its prognosis depends on the moment of appearance of the symptoms, so it may be classified as of early onset when it appears before the 4 days of ventilation. It is produced by germs from the oropharynx and is associated with low mortality and its prognosis is generally good. The late onset pneumonia arises after 5 days of ventilatory support. It is caused by multiresistant strains and its prognosis is very poor. The diagnosis is difficult due to the multiple criteria proposed in different studies. Those made by the American Thorax Association, in 1999, are more specific, since they have the clinical, microbiological and non-microbiological conditions, which are non-invasive, they may be established easily and fast and can be applied to any age group, independently of the cause of the disease. The direct microscopic analysis and the knowledge of the epidemiological map of each service, allow to use a more effective empiric treatment. Although monotherapy is the present trend, there is not an ideal antibiotic covering the whole spectrum of microorganisms responsible for this entity.

Palavras-chave : PNEUMONIA; CROSS INFECTION; RESPIRATION, ARTIFICIAL.

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