Characteristics and Outcomes in Patients with Ventilator-Associated Pneumonia Who Do or Do Not Develop Acute Respiratory Distress Syndrome. An Observational Study.

Autor: Barbeta E; Department of Pneumology and Respiratory Intensive Care Unit, Institut Clinic de Respiratori, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028), 08036 Barcelona, Spain.; Intensive Care Unit, Hospital Universitari Sagrat Cor, CIBER Enfermedades Respiratorias, 08036 Barcelona, Spain., Ceccato A; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028), 08036 Barcelona, Spain.; Intensive Care Unit, Hospital Universitari Sagrat Cor, CIBER Enfermedades Respiratorias, 08036 Barcelona, Spain., Artigas A; Critical Care Center, Corporación Sanitaria Universitaria Parc Tauli, CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, 08208 Sabadell, Spain., Ferrer M; Department of Pneumology and Respiratory Intensive Care Unit, Institut Clinic de Respiratori, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028), 08036 Barcelona, Spain., Fernández L; Department of Pneumology and Respiratory Intensive Care Unit, Institut Clinic de Respiratori, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028), 08036 Barcelona, Spain., López R; Department of Pneumology and Respiratory Intensive Care Unit, Institut Clinic de Respiratori, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028), 08036 Barcelona, Spain., Bueno L; Department of Pneumology and Respiratory Intensive Care Unit, Institut Clinic de Respiratori, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028), 08036 Barcelona, Spain., Motos A; Department of Pneumology and Respiratory Intensive Care Unit, Institut Clinic de Respiratori, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028), 08036 Barcelona, Spain., Bassi GL; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD 4032, Australia., Mellado R; Department of Anesthesiology and Surgical Intensive Care Unit, Hospital Clinic of Barcelona, 08036 Barcelona, Spain., Ferrando C; Department of Anesthesiology and Surgical Intensive Care Unit, Hospital Clinic of Barcelona, 08036 Barcelona, Spain., Palomeque AC; Department of Pneumology and Respiratory Intensive Care Unit, Institut Clinic de Respiratori, Hospital Clinic of Barcelona, 08036 Barcelona, Spain., Panigada M; Anesthesia, Intensive Care and Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy., Gabarrús A; Department of Pneumology and Respiratory Intensive Care Unit, Institut Clinic de Respiratori, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028), 08036 Barcelona, Spain., de Mendoza D; Intensive Care Unit, Hospital Universitari Sagrat Cor, CIBER Enfermedades Respiratorias, 08036 Barcelona, Spain., Torres A; Department of Pneumology and Respiratory Intensive Care Unit, Institut Clinic de Respiratori, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028), 08036 Barcelona, Spain.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2020 Oct 29; Vol. 9 (11). Date of Electronic Publication: 2020 Oct 29.
DOI: 10.3390/jcm9113508
Abstrakt: Ventilator-associated pneumonia (VAP) is a well-known complication of patients on invasive mechanical ventilation. The main cause of acute respiratory distress syndrome (ARDS) is pneumonia. ARDS can occur in patients with community-acquired or nosocomial pneumonia. Data regarding ARDS incidence, related pathogens, and specific outcomes in patients with VAP is limited. This is a cohort study in which patients with VAP were evaluated in an 800-bed tertiary teaching hospital between 2004 and 2016. Clinical outcomes, microbiological and epidemiological data were assessed among those who developed ARDS and those who did not. Forty-one (13.6%) out of 301 VAP patients developed ARDS. Patients who developed ARDS were younger and presented with higher prevalence of chronic liver disease. Pseudomonas aeruginosa was the most frequently isolated pathogen, but without any difference between groups. Appropriate empirical antibiotic treatment was prescribed to ARDS patients as frequently as to those without ARDS. Ninety-day mortality did not significantly vary among patients with or without ARDS. Additionally, patients with ARDS did not have significantly higher intensive care unit (ICU) and 28-day mortality, ICU, and hospital length of stay, ventilation-free days, and duration of mechanical ventilation. In summary, ARDS deriving from VAP occurs in 13.6% of patients. Although significant differences in clinical outcomes were not observed between both groups, further studies with a higher number of patients are needed due to the possibility of the study being underpowered.
Competing Interests: The authors declare to not have any conflicts of interest.
Databáze: MEDLINE
Externí odkaz: