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Characterization of post-surgical critical patients with infections associated with healthcare after prolonged perfusion of remifentanil

García, José Luis Bonilla ; Sáenz, Manuel Cortiñas ; Gavilán, Esperanza Del Pozo

Revista da Associacao Medica Brasileira (1992), 2018-08, Vol.64 (8), p.736-742 [Periódico revisado por pares]

Brazil

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Título:
Characterization of post-surgical critical patients with infections associated with healthcare after prolonged perfusion of remifentanil
Autor: García, José Luis Bonilla ; Sáenz, Manuel Cortiñas ; Gavilán, Esperanza Del Pozo
Assuntos: Aged ; Analgesics, Opioid - administration & dosage ; Anesthesia, Local - adverse effects ; Anesthesia, Local - methods ; APACHE ; Critical Illness ; Cross Infection - epidemiology ; Cross Infection - microbiology ; Deep Sedation - adverse effects ; Deep Sedation - methods ; Female ; Hospitalization - statistics & numerical data ; Humans ; Hypnotics and Sedatives - administration & dosage ; Klebsiella pneumoniae - isolation & purification ; Male ; Midazolam - administration & dosage ; Middle Aged ; Pneumonia, Ventilator-Associated - epidemiology ; Pneumonia, Ventilator-Associated - microbiology ; Postoperative Complications - epidemiology ; Postoperative Complications - microbiology ; Propofol - administration & dosage ; Prospective Studies ; Pseudomonas aeruginosa - isolation & purification ; Remifentanil - administration & dosage ; Risk Factors ; Spain - epidemiology ; Time Factors
É parte de: Revista da Associacao Medica Brasileira (1992), 2018-08, Vol.64 (8), p.736-742
Descrição: Healthcare associated infections (HAI) are the most frequent complication of hospitalized patients. The aim of this study was to describe the clinical and epidemiological characteristics of critically ill post-surgical patients with a diagnosis of healthcare associated infections, after a pattern of sedoanalgesia of at least 4 days. All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology where sedation was based as analgesic the opioid remifentanil for at least 96 hours in continuous perfusion. Patients who died during admission to the unit and those with combined analgesia (peripheral or neuroaxial blocks) were excluded. Data analysis was performed using the statistical package Stata version 7.0. The patients admitted to the Post-Surgical Critical Care Unit (PCU) during study were 1789 and the population eligible was comprised of 102 patients. 56.86% of patients suffered IACS. The most frequent IACS was pneumonia associated with mechanical ventilation (30.96 per 1000 days of mechanical ventilation), Pseudomonas aeruginosa being the most frequently isolated germ. The germs with the greatest involvement in multiple drug resistance (MDROs) were enterobacteria, mainly Klebsiella pneumoniae resistant to extended-spectrum beta-lactamases (ESBL). Pneumonia associated with mechanical ventilation is the most prevalent HAI and Pseudomonas aeruginosa is the main etiological agent. The groups of antibiotics most frequently used were cephalosporin and aminoglycosides. It is necessary to implement the prevention strategies of the different HAI, since most of them are avoidable.
Editor: Brazil
Idioma: Inglês

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Characterization of post-surgical critical patients with infections associated with healthcare after prolonged perfusion of remifentanil

García, José Luis Bonilla ; Sáenz, Manuel Cortiñas ; Gavilán, Esperanza Del Pozo

Brazil

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