INCIDENCE AND RISK FACTORS OF VAP IN TETANUS PATIENTS

Abstract

BACKGROUND:

Tetanus is a disease that is becoming increasingly infrequent in developed countries., but it is still a leading cause of death globally, with a significant mortality rate, particularly in developing countries(1) . Tetanus necessitates a large number of ICU resources, as well as a six-week course of tetanus that necessitates ICU admissions and prolonged mechanical breathing(2). .

Ventilator associated pneumonia is a kind of nosocomial infection that develops in individuals who have been on mechanical ventilators for more than 48 hours and is linked to longer hospital stays, greater morbidity, and mortality(3)(4) .The most prevalent consequence in ICU patients is ventilator-associated pneumonia, which affects 9 percent to 68 percent of patients(5).

Ventilator associated pneumonia is linked to Tetanus severity, dysautonomy, neuromuscular blockers, a greater diazepam dose, intravenous sedation, the use of a paralytic agent, less oxygen in the blood and a reduced oxygen percentage, co morbid factors, mechanical ventilation for a long time, endotracheal intubation, Re- intubation, ,tracheostomy, emergency intubation, as well as the primary trauma diagnosis, past episodes of gastric aspiration, microaspiration of colonised orophyangeal secretion, antibiotic pretreatment, nasogastric tubes, supine body posture, dialysis, and higher APACHE II scores) (6)(7)(8)(9)(10)(5)(11)(12)(13).

Several elements have an impact on incidence of ventilator associated pneumonia, the most important of which are the host, the duration of mechanical breathing, the confidence interval, enteral feeding, and a low degree of consciousness (5). VAP can be divided into two types: early on set (less than five days) and late on set (more than five days). The total incidence of VAP ranges from 9% to 70% on average (20% to 25%), with the majority of episodes occurring within the first five days. (13).

Tetanus is a potentially lethal condition(14), and VAP, a consequence of tetanus, increases ICU patient mortality by 30 to 70%(15) , therefore we addressed incidence and risk factors of VAP to reduce its mortality and morbidity.

METHOD

From December 2019 to June 2021, we undertake a systematic review using data from Google Scholar and PubMed. Incidence and risk factors of VAP in tetanus patients were discovered as a consequence of the search. We analyze following risk factors as mentioned above in the background.

RESULT

Four investigations, both prospective and retrospective, with varying sample sizes and settings, yielded results that met our eligibility criteria. The risk factors in all four researches were the same, but the incidence varied.

CONCLUSION

We find that tetanus is a potentially deadly disease based on the information presented(14). VAP is a tetanus consequence that increases ICU patient mortality by 30 to 70 percent (15). Patients with tetanus had a higher rate of VAP than those with meningitis or other neurological disorders. (5), here we wish to undertake a systemic review to gain a better understanding the prevalence of ventilator associated pneumonia and the risk factors linked with it so that more effective preventative measures may be developed and used to reduce mortality and morbidity.