Objective To investigate the correlation factors of ventilator-associated pneumonia（VAP） in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） and nursing intervention strategies to provide a reference for clinical treatment. Methods A total of 112 patients with AECOPD who underwent mechanical ventilation from January 2020 to November 2021 were selected as the study subjects. Patients were assigned to the occurrence group（n=47） and the non-occurrence group（n=65） following whether ventilator-associated pneumonia occurred during treatment. To analyze the distribution of infectious pathogens in patients with ventilator-associated pneumonia. Clinical data such as age

gender

ventilator ventilation time

route of nutritional support

whether or not to use acid suppressants

presence of or free from diabetes mellitus

indwelling gastric tube

and smoking history were collected. Multivariate logistic regression analysis was used to analyze the risk factors in patients with ventilator-associated pneumonia. Results A total of 59 strains of pathogenic bacteria were isolated and cultured from 47 patients with ventilator-associated pneumonia

24 strains of gram-positive bacteria（38.98%）

31 strains of gram-negative bacteria（52.54%）

and 4 strains of fungi（6.78%）. The proportion of patients aged over 60 years or more

ventilator ventilation time ≥4 d

total intravenous nutritional support

use of acid suppressants

combined diabetes

indwelling gastric tube

and smoking history in the occurred group were significantly higher than those in the non-occurred group（P<0.05）. The results of multivariate logistic regression analysis showed that ventilator ventilation time ≥4 d

total intravenous nutritional support

and use of acid suppressants were independent risk factors for ventilator-associated pneumonia in patients with AECOPD（P<0.05）. Conclusion Patients with AECOPD have a high risk of ventilator-associated pneumonia and are mostly infected with gram-negative bacteria. Independent risk factors for ventilator-associated pneumonia in patients with AECOPD included ventilator ventilation time ≥4 days

total intravenous nutritional support

and use of acid suppressants. Clinical nursing intervention for patients with AECOPD should be performed following the above factors: adjusting the duration of mechanical ventilation

weaning patients from ventilators as early as possible; strengthening the physical function training of patients

and giving patients enteral nutrition support as early as possible; improve the postoperative dietary structure of patients

hence reduce the risk of massive reproduction of pathogenic bacteria in the stomach and transfer of infection.