<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092023000300219</article-id>
<article-id pub-id-type="doi">10.35366/111298</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Utilidad del protocolo Neumonía Zero modificado para disminuir la incidencia de neumonía asociada a la ventilación mecánica en la UCI del Hospital Regional ISSSTE Morelia]]></article-title>
<article-title xml:lang="en"><![CDATA[Usefulness of the modified Neumonia Zero protocol to reduce the incidence of pneumonia associated with mechanical ventilation in the ICU of the ISSSTE Morelia Regional Hospital]]></article-title>
<article-title xml:lang="pt"><![CDATA[Utilidade do protocolo Zero Pneumonia modificado para reduzir a incidência de pneumonia associada à ventilação mecânica na UTI do Hospital Regional ISSSTE Morelia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Medina López]]></surname>
<given-names><![CDATA[Jorge Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camacho Carrasco]]></surname>
<given-names><![CDATA[Miriam Nicte]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>37</volume>
<numero>3</numero>
<fpage>219</fpage>
<lpage>223</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092023000300219&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092023000300219&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092023000300219&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La neumonía asociada a la ventilación mecánica en la actualidad se considera una emergencia mundial debido a que los microorganismos causales han generado resistencia antimicrobiana. En un estudio retrospectivo que se realizó en nuestra unidad de cuidados intensivos (UCI) se encontraron 206 ingresos anuales, que corresponden al periodo del 15 de enero de 2021 al 15 de diciembre de 2021; se detectaron 83 cultivos positivos de secreción bronquial que corresponden a 40.2% del total de ingresos con una tasa de incidencia de 41% anual. Del total del estudio, 35 de los cultivos corresponden a Acinetobacter baumannii (16.9%), Stenotrophomonas maltophilia siete cultivos positivos (4.35%), Staphylococcus aureus ocho (3.87%), Pseudomonas sp. siete cultivos positivos (3.39%), E. coli siete cultivos positivos (3.39%), Staphylococcus epidermidis seis cultivos (2.90%), Klebsiella pneumoniae cuatro cultivos (1.93%), Enterococcus faecalis dos cultivos (0.06%), S. marcescens y Streptococcus pneumoniae con un cultivo respectivamente (0.48%). Por todo esto, es necesario efectuar medidas que disminuyan dicha incidencia, la magnificación de este proyecto al estimar los altos costos diarios de la UCI puede reducir estos costos a la institución. El objetivo de este estudio es generar medidas preventivas para disminuir la incidencia de neumonía asociada a la ventilación mecánica en la Unidad de Cuidados Intensivos del Hospital Regional Morelia ISSSTE. El estudio consiste en implementar el protocolo Neumonía Zero modificado que consta de siete acciones preventivas, las cuales son: 1) Posición de cabecera entre 20 y 35o. 2) Evitar el cambio rutinario de circuito de ventilador. 3) Realizar aseo con clorhexidina previo a aspiración de secreciones. 4) Aseo de manos con soluciones alcoholadas previo a aspiración de secreciones. 5) Verificar presión de globo de neumotaponamiento (20-25 mmHg) previo a aspiración de secreciones. 6) Realizar acciones diarias que disminuyan las sedaciones. 7) Colocar sonda orogástrica de calibre 14 Fr. Se elaboró una lista de verificación (checklist) y se revisaron las siete acciones llenando por turno durante el periodo de implementación del estudio.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Ventilator-associated pneumonia is currently considered a global emergency because the causative microorganisms have generated antimicrobial resistance. In a retrospective study that was carried out in our intensive care unit, 206 annual admissions were found, of which they correspond from January 15, 2021 to December 15, 2021; 83 positive cultures of bronchial secretion were found, corresponding to 40.2% of all admissions, with an annual incidence rate of 41%. Of the total study, 35 cultures correspond to Acinetobacter baumannii (16.9%), Stenotrophomonas maltophilia; seven positive cultures (4.35%), Staphylococcus aureus eight corresponding to (3.87%), Pseudomonas sp. seven positive cultures (3.39%), E. coli seven positive cultures (3.39%), Staphylococcus epidermidis six cultures (2.90%), Klebsiella pneumoniae four cultures (1.93%), Enterococcus faecalis two cultures (0.06%), S. marcescens and Streptococcus pneumoniae with one culture respectively (0.48%); for all this it is necessary to carry out measures that reduce said incidence, the magnification of this project by estimating the high daily costs of the intensive care unit can reduce the costs to the institution. The objective of this study is to generate preventive measures to reduce the incidence of pneumonia associated with mechanical ventilation in the ICU of the Morelia ISSSTE Regional Hospital. The study consists of implementing the modified Neumonia Zero protocol that consists of seven preventive actions which are: 1) Head position between 20 and 35o. 2) Avoid routine change of fan circuit. 3) Perform cleaning with chlorhexidine prior to aspiration of secretions. 4) Clean hands with alcohol solutions prior to aspiration of secretions. 5) Verify pressure of the pneumotamponade balloon (20-25 mmHg) prior to aspiration of secretions. 6) Carry out daily actions that reduce sedation. 7) Place a 14 Fr orogastric tube. A checklist was made and the seven actions per shift were reviewed, filling in per shift, during the implementation period of the study.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: A pneumonia associada à ventilação mecânica é atualmente considerada uma emergência global porque os microrganismos causadores geraram resistência antimicrobiana. Em estudo retrospectivo realizado em nossa unidade de terapia intensiva, foram encontradas 206 internações anuais, das quais correspondem de 15 de janeiro de 2021 a 15 de dezembro de 2021; encontrou-se 83 culturas de secreção brônquica positivas, correspondendo a 40.2% do total de internações com taxa de incidência anual de 41%. Do total do estudo, 35 das culturas correspondem a Acinetobacter baumannii (16.9%), Stenotrophomonas maltophilia; 7 culturas positivas (4.35%), Staphylococcus aureus 8 correspondente a (3.87%), Pseudomonas sp. 7 culturas positivas (3.39%), E. coli 7 culturas positivas (3.39%) Staphylococcus epidermidis 6 culturas (2.90%), Klebsiella pneumoniae 4 culturas (1.93%), Enterococcus faecalis 2 culturas (0.06%) S. marcescens e Streptococcus pneumoniae com 1 cultura respectivamente (0.48%); por tudo isto, é necessário realizar medidas que reduzam a referida incidência. A ampliação deste projeto estimando os elevados custos diários da unidade de cuidados intensivos pode reduzir os custos para a instituição. O objetivo deste estudo é gerar medidas preventivas para reduzir a incidência de pneumonia associada à ventilação mecânica na UTI do Hospital Regional Morelia ISSSTE. O estudo consiste na implementação do protocolo Neumonia Zero modificado que consiste em 7 ações preventivas que são: 1) Posição da cabeça entre 20 e 35o. 2) Evite a mudança de rotina do circuito do ventilador. 3) Limpar com clorexidina antes da aspiração de secreções. 4) Realizar a higiene das mãos com soluções alcoólicas antes da aspiração de secreções. 5) Verifique a pressão do balão de pneumotamponamento (20-25 mmHg) antes da aspiração de secreções. 6) Realizar ações diárias que reduzam a sedação. 7) Colocar um tubo orogástrico de calibre 14. Realizou-se uma lista de verificação checklist e foram revisadas as sete ações por turno, preenchendo por turno, durante o período de implementação do estudo.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[neumonía asociada a la ventilación mecánica]]></kwd>
<kwd lng="es"><![CDATA[resistencia microbiana]]></kwd>
<kwd lng="es"><![CDATA[acciones preventivas]]></kwd>
<kwd lng="en"><![CDATA[pneumonia associated with mechanical ventilation]]></kwd>
<kwd lng="en"><![CDATA[microbial resistance]]></kwd>
<kwd lng="en"><![CDATA[preventive actions]]></kwd>
<kwd lng="pt"><![CDATA[pneumonia associada à ventilação mecânica]]></kwd>
<kwd lng="pt"><![CDATA[resistência microbiana]]></kwd>
<kwd lng="pt"><![CDATA[ações preventivas]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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