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Serbian Journal of Anesthesia and Intensive Therapy
2014, vol. 36, br. 1-2, str. 109-116
jezik rada: srpski
vrsta rada: pregledni članak

Pneumonija udružena sa ventilatornom potporom bolesnika
aMedicinski fakultet, Novi Sad + Klinički centar Vojvodine, Novi Sad
bMedicinski fakultet, Beograd + Centar za anesteziologiju i reanimatologiju Kliničkog centra Srbije, Beograd
cKlinički centar Vojvodine, Novi Sad
dKlinički centar Novi Sad

e-adresa: profgvozdenovic2010@hotmail.com

Sažetak

Pneumonija udružena sa ventilatornom potporom bolesnika (VAP) je vrsta intrahospitalne infekcije i definiše se kao pneumonija, nastala 48 sati nakon intubacije bolesnika i započinjanja mehaničke ventilacije . Učestalost je 8-28% intubiranih bolesnika i udružena je sa visokom stopom mortaliteta, od 33- 50%. Uzročnici su obično bakterije, a u zavisnosti od vremena nastanka uzrokovana je osetljivim ili rezistentnim sojevima bakterija. Primarni put dospevanja patogena u traheju je kroz tubus - aspiracijom, ili difundovanjem bakterija oko kafa endotrahealnog tubusa. Praćena je visokom stopom mortaliteta, povećanom cenom i dužinom lečenja, te se velika pažnja pridaje nefarmakološkim i farmakološkim merama prevencije njenog nastanka. Krucijalnu ulogu ima rana dijagnoza od koje zavisi izbor antibiotika. Dijagnoza se bazira na kliničkoj slici, radiografskom nalazu i mikrobiološkim rezultatima. Terapija se sprovodi jednim antibiotikom - monoterapija ili kombinacijom više antibiotika. Izbor antibiotika zavisi od vremena nastanka pneumonije u odnosu na početak mehaničke ventilacije i prisustva faktora rizika za nastanak infekcije uzrokovane multirezistentnim sojevima bakterija. Optimalna antibiotska terapija predstavlja ključ uspešnog lečenja bolesnika sa ventilator udruženom pneumonijom.

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