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Ventilator-associated pneumonias in children ( ii ) - prophylaxis and treatment

 

Tonyo Il. Shmilev1 / Ivan V. Yankov 2
1Department of Pediatrics and Medical Genetics, Medical University, Plovdiv, Bulgaria
2Department of Pediatrics and Medical Genetics, Medical University, Plovdiv, Bulgaria
Correspondence and reprint request to: T. Shmilev, Department of Pediatrics and Medical Genetics, Medical University,Plovdiv; E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.; Mob.: +359 894 397 57815A Vassil Aprilov St, 4002 Plovdiv, Bulgaria

Citation Information: Folia Medica. Volume 54, Issue 1, Pages 12–18, ISSN (Online) 1314-2143, ISSN (Print) 0204-8043, DOI: 10.2478/v10153-011-0072-z, October 2012
Publication History:
Published Online:
2012-10-24


ABSTRACT

 

Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection among children treated in intensive care units. The risk factors for developing this condition are generated by the patient’s bedside conditions, the equipment used and the specifi c treatment administered to the child. Prophylaxis of VAP should necessarily include all measures that have been proven to be effi cient in this respect such as rigorous hygiene control of hands and protective clothing of attending staff, changing breathing circuits of ventilators only if they malfunction or if they are visibly contaminated, preference of orotracheal intubation (instead of nasotracheal intubation) and use of endotracheal tubes with dorsal lumens to allow respiratory secretions to drain, and introduction of a uniform approach to patient care and staff training. Prophylaxis of the microbial colonization in children by antibiotics does not reduce the incidence of VAP-causing poly-resistant bacteria. Therapeutic management includes early initiation of broad spectrum empirical antibiotic therapy, the right choice of antibiotic requiring regular monitoring and good knowledge of the antibiotics sensitivity of the most common microbial isolates in the ward.