A Clinical Study On The Relationship Between Early Termination Of Proton Pump Inhibitors And The Incidence Of Ventilator-associated Pneumonia

Objective: Analysis the effect of the beginning of enteral nutrition as stop time for Proton pump inhibitor on the incidence rate of ventilator-associated pneumonia,the incidence rate of stress ulcer,total tracheal intubation time,Intensive Care Unit stay days and mortality rate in ICU patients,so as to provide theoretical basis for selecting the stopping time of PPIs.Methods: Through the eastern soft medical record system,the patients who used PPIs during mechanical ventilation from December 2017 to December 2019 in the ICU of a hospital were selected.The patients who stopped using PPIs at the beginning of enteral nutrition were listed as the early termination group,and the patients who stopped using PPIs at the other courses(extubation,transfer out of ICU,discharge,etc.)were listed as the control group.The age,gender,primary disease,albumin level,APACHE II,incidence rate of VAP,incidence rate of SU,total tracheal intubation time,stay days in ICU,mortality and other indicators between the two groups were analyzed.Spss21.0 software was used for data statistical analysis.The counting data between the two groups were compared by chi square test.Independent sample T test is adopted for measurement data;19 cases of VAP in the total sample were finally listed as VAP group,and the remaining patients were listed as non VAP group.The general data were analyzed by single factor analysis,and the significant factors were further analyzed by binary logistic regression model,P<0.05 was statistically significant.Results:(1)There were 104 patients included in this study,including 46 patients in the early termination group and 58 in the control group.The incidence of VAP,the time of general tracheal intubation and the time of stay in ICU in the early termination group were significantly lower than those in the control group(P<0.05).(2)there was no significant difference in the incidence and mortality of Su between the early termination group and the control group(P>0.05).(3)there were 19 patients in the VAP group and no VAP group in the total sample There were significant differences in age,primary disease,albumin,body weight and APACHE II between the two groups(P<0.05).There was a significant positive correlation between age and VAP(P<0.05).There was no significant correlation between VAP and primary disease,body weight,aphche ? score(P>0.05).Conclusion:(1)Termination of PPIs at the beginning of enteral nutrition can effectively reduce the incidence of VAP.(2)Termination of PPIs at the beginning of enteral nutrition did not increase the incidence of SU.(3)Termination of PPIs at the beginning of enteral nutrition can effectively reduce intubation time and ICU stay time.(4)The older the age,the lower the albumin level,and the more susceptible the patients were to VAP.