Author/Editor		Krizman, Laura
Title		Pojav bolnišničnih okužb pri pacientih z zunanjo likvorsko drenažo
Translated title		Emergence nosocomial infections in patients with external cerebrospinal fluid drainage
Type		članek
Source		In: Kakovost v zdravstveni in babiški negi - odgovorni, kompetentni in inovativni zaposleni: zbornik predavanj in posterjev 2. Znanstvenega simpozija z mednarodno udeležbo Maribor : Društvo medicinskih sester, babic in zdravstvenih tehnikov
Publication year		2009
Volume		str. 251-257
Language		slv
Abstract		Izhodišča: Zunanje likvorske drenaže se v nevrokirurgiji uporabljajo za terapevtsko odvajanje cerebrospinale tekočine pri povišanem intrakranialnem tlaku. Kot pri drugih vstavljenih implantatih, obstaja tveganje za pojav okužbe tudi pri zunanji likvorski drenaži, katera je povezana z obolevnostjo in umrljivostjo. V svetu poročajo o 22% incidenci okužb, povezani z zunanjo likvorsko drenažo. Z raziskavo smo želeli ugotoviti incidenco pojava bolnišničnih infekcij v naši kliniki, s poudarkom na ventrikulitisu. Metoda: Uporabljena je deskriptivna metoda v longitudinalni študiji. V raziskavo so vključeni vsi pacienti z zunanjo likvorsko drenažo, po subarahnoidni krvavitvi, ki so zdravljeni v avtorjevi instituciji, v času od 1. januarja 2000 do 31. decembra 2006. Statistični podatki so bili pridobljeni iz medicinske dokumentacije z vsemi potrebnimi soglasji. Cilj raziskave je bil vključiti le paciente z zunanjo ventikularno likvorsko drenažo. Rezultati: V raziskavi je bilo vključenih 44 pacientov (69,2% žensk in 31,8% moških), povprečna starost 50,9 let. Povprečna ležalna doba je bila 39,4 dni. Ventricullitis je bil zabeležen v 40,1%. Zaradi dihalne stiske je pri 16 bolnikih bila potrebna traheotomija, pri katerih 75% bolnikov razvilo okužbo dihal (36,3% vseh udeleženih v raziskavi), ter 27,2% bolnikov je bilo koloniziranih z MRSA. Razprave in sklepi: Zapleti pri bolnikih s subarahnoidno krvavitvijo so pogosti. Raziskava je pokazala večjo pojavnost bolnišničnih okužb, kot se o njih poroča v svetu, kar pa je posledica časovno dolgoročne drenaže, večkratnega ponovnega vstavljanja pri psihično nestabilnih pacientih in težkega zdravstvenega stanja pacientov. Sprejeti so bili novi ukrepi. Od začetka leta 2009 teče nova študija, pri kateri preliminirani rezultati že kažejo pomembno nižjo incidenco pojava ventrikulitisa.Background: External cerebrospinal fluid drainage in neurosurgery is used for therapeutic drainage of cerebrospinal fluid for elevated intracranial pressure. As with other implanted implants, there is a risk of infection in the external cerebrospinal fluid drainage, which is associated with morbidity and mortality. Reported incidence of infection associated with external ventricular drainage is up to 22%. The survey we wanted to determine the incidence of the occurrence of nosocomial infections in our clinic, with an emphasis on ventricullitis. Method: Descriptive methods were used in the longitudinal study. All patients with cerebrospinal fluid drainage after subarachnoid haemorrhage treated at authorćs institution from January 1st 2000 to December 31st 2006 were included in the study. Statistical data were obtained from medical documentation with all necessary consents. Research aim was to include only the patients with ventricular external drainage. Results: The study involved 44 patients, (69,2% women and 31,8% men), mean age 50.9 years. Average hospitalization was 39,4 days. Ventricullitis was recorded in 40.1%. Because the respiratory distress in 16 patients was required tracheotomy, where 75% of patients developed respiratory infection (36.3% of all involved), and 27.2% were colonized with MRSA. Discussion and conclusions: Complications in patients with subarachnoid haemorrhage are often. The survey showed a greater incidence of hospital infections then was reported in the world. This is due to the long-term drainage, multiple insertions in turbulent patients, accompanying diseases and heavy health status of patients. Since 2009, in the course of the new study, whose preliminary results already show a significant lower incidence of ventricular infection due to new measures in the way of drainage.
Descriptors		Subarachnoid Hemorrhage Subarahnoidna krvavitev Cerebrospinal Fluid Cerebrospinalna tekočina Drainage Drenaža Cross Infection Infekcija, navzkrižna