BACKGROUND: Today, as many as 1.5 million Americans use VENTILATORs once in a year. Response to mechanical ventilation alarms remains to be one of the most challenging tasks facing physicians, nurses or other medical personnel in the ICU. In the present study we aimed to compare the response times to “vocal alarms” and “visual or audible ones”.METHODS: In the present study we developed a system to evaluate the “Vocal Alarm” and improve the medical VENTILATOR“Benet 7200 Alarms” with it. VENTILATOR generates the alarms when patient has any problem. The time of Activation and Deactivation is recorded. The survey was done in central ICU for six days, 3 days with vocal alarm, and 3days with“Beep” alarms and detected Alarm events then recorded seventy-two hours of data for each type of alarms. All of events information saved in the memory and SPSS was used to determine difference between two types of alarms.RESULTS: On the average, the duration of the VENTILATOR alarms activation were 33±21 seconds for vocal alarms and 60±46 for audible “Beep” alarms. The response times for vocal alarms were significantly lower (P=0.001).CONCLUSIONS: The response times for normal “Beep” alarms were longer than vocal alarms.

Background: Hospital acquired infections are associated with prolonged hospitalization and visibly increased mortality & cost. VENTILATOR-associated pneumonia (VAP) is one of the most common hospital-acquired infections VAP complicates the course of 9-70% % of mechanically ventilated patients and mortality varies greatly from 20-25% depending on the defining criteria and specific population being studied. As little is known about the epidemiology, risk factors, and microbiology of VAP in pediatrics we conducted this study to find most common micro-organisms and related risk factors.Materials and methods: We select 1-15 months intubated pediatric patients in Ali- Asghar children hospital in Tehran from 1388 up to end of 1389. 63 cases (36 male & 27 female) were included in this study with mean age 22.32±37.84 months. We identified 26 cases with VAP by positive protected bronchial brush. There was no differences between two groups of patients with & without VAP by considering variables such as nasogastric tube, head position, antacid administration, immunosuppressant drugs & chest physiotherapy.Results: The most common organisms, were Pseudomonas aeuroginosa, Staphylococcus aureus & Enterobacter. However, there was no differences between two groups related to the etiologic agents. Conclusion: The findings of this study suggest that most of the complications defined as VAP are patient-related, not modifiable risk factors and it seems that the new prevention strategies are needed to decrease the mortality in intensive care unit patients.

Introduction: Regarding the role of probiotics in the balance of aerodigestive microorganism in the digestive system and the central role of bacteria colonization in the pathogenesis of VENTILATOR associated pneumonia (VAP), the propose of this study was to investigate the effect of probiotics in prevention from ventilation associated pneumonia in ICU patients, who were undergoing mechanical ventilation with high risk for VAP.Materials and Methods: Patients (n=60) hospitalized at ICU of Valiasr Hospital, Arak, Iran participated in a randomized, double-blind, placebo-controlled clinical trial. Patients were randomly divided into two groups (intervention and placebo). Intervention group received Lactobacillus rhamnosus Gagavage three times a day in addition to a routine care. Control group received placebo in addition to a routine care. Demographic and clinical data were recorded and clinical response to primary outcome (prevalence of VAP) and secondary (other clinical factors) was interpreted. Data were analyzed in SPSS 18, using student t-test and chi-square.Results: Twenty two patients (36.6%) were diagnosed with VAP, of which, 7 (23.3%), and 15 (50%) patients were in the probiotic and control groups, respectively. (p=0.03). The average of days spent in ICU (intervention: 14.2±4.7 vs control: 17.6±6.5, p=0.028), hospitalization (intervention: 24.1±5.6 vs control: 27.4±6.6, p=0.041), and number of patients with diarrhea caused by clostridium difficile (intervention: 1(23.3%) vs control: 6 (20%), p=0.04), were significantly lower in the probiotic group than the placebo group. The mean of intubation time till receiving VAP (intervention: 10.5±1.02 vs Control: 6.1±2.6, p=0.008) and full recovery (intervention: 25 (83.3%) vs control: 14 (46.6), p=0.028) were significantly higher in the intervention than the control group.Conclusion: These findings successfully presented that probiotics could effectively protect from VAP in a selected, high-risk ICU patients. As a result, the use of this therapy, in patients undergoing long-term intubation is recommended.