Effects of a Simple Protocol on Infective Complications in Intensive Care Unit Patients Undergoing Percutaneous Dilatational Tracheostomy

Authors: Jacobs, Sydney1; Rasheed, Abdul Mohsen Al2; Abdulsamat, Wadood2; Barrak, Ali Al3; Omer, Nasser Fawzan Al4; Tjan, David5; Zuleika, Mehrun5; Ahmed, Faham5; Enani, Mushera3

Source: Respiratory Care, Volume 48, Number 1, January 2003 , pp. 29-37(9)

Publisher: The Journal Respiratory Care Company

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Abstract:

In our intensive care unit we monitored infection in 228 patients who underwent percutaneous dilatational tracheostomy (PDT). In the first phase of the study 128 PDTs were performed during a 33-month period and there were 41 infection complications (nosocomial pneumonia, bacteremia with sepsis, and septic shock) in the perioperative period (immediately prior to and for 5 days after PDT). A significant risk factor among patients with nosocomial pneumonia was empirical administration of inappropriate antibiotics, compared to appropriate antibiotics (34% versus 4%, p < 0.001). In the second phase of the study (a 30-month period), a simple antibiotics protocol was prospectively applied to 100 PDT patients. The protocol virtually eliminated inappropriate antibiotic drug use immediately prior to PDT and contributed to a significant reduction in perioperative infective complications (pre-protocol 32% versus protocol 11%, p < 0.001).

Keywords: INFECTION CONTROL; INTENSIVE CARE; NOSOCOMIAL PNEUMONIA; PERCUTANEOUS DILATATIONAL TRACHEOSTOMY; SEPSIS

Document Type: Research Article

Affiliations: 1: Department of Anaesthesia and Intensive Care, X994 Riyadh Armed Forces Hospital, PO Box 7897, Riyadh 11159, Kingdom of Saudi Arabia;, Email: dney@nesma.net.sa 2: Department of Microbiology, Riyadh Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia 3: Infectious Disease Unit, Department of Medicine, Riyadh Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia 4: Department of Pharmacy, Armed Forces Hospital, Riyadh Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia 5: Department of Anesthesia and Intensive Care, Riyadh Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia

Publication date: January 1, 2003

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