Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration.

Autor: Levy C; Department of Intensive Care Medicine, Critical Care Center, CHU Lille, 59000 Lille, France., Gaudet A; Department of Intensive Care Medicine, Critical Care Center, CHU Lille, 59000 Lille, France.; U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Institut Pasteur de Lille, CNRS, Inserm, CHU Lille, University Lille, 59000 Lille, France., Jaillette E; Department of Intensive Care Medicine, Critical Care Center, CHU Lille, 59000 Lille, France., Reignier J; Department of Intensive Care Medicine, CHU Nantes, 44000 Nantes, France., Lassailly G; Department of Hepatology & Gastroenterology, CHU Lille, 59000 Lille, France., Balduyck M; Department of Biochemistry, CHU Lille, 59000 Lille, France., Cailliau E; Department of Biostatistics, CHU Lille, 59000 Lille, France., Rouze A; Department of Intensive Care Medicine, Critical Care Center, CHU Lille, 59000 Lille, France.; UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, CNRS, Inserm U1285, Université de Lille, 59000 Lille, France., Nseir S; Department of Intensive Care Medicine, Critical Care Center, CHU Lille, 59000 Lille, France.; UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, CNRS, Inserm U1285, Université de Lille, 59000 Lille, France., On Behalf Of The Micro Cirrhosis Study Group
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Oct 11; Vol. 11 (20). Date of Electronic Publication: 2022 Oct 11.
DOI: 10.3390/jcm11205994
Abstrakt: Previous studies have identified cirrhosis as a risk factor for ventilator-associated pneumonia (VAP). The aim of our study was to determine the relationship between cirrhosis and abundant gastric-content microaspiration in intubated critically ill patients. We performed a matched cohort study using data from three randomized controlled trials on abundant microaspiration in patients under mechanical ventilation. Each cirrhotic patient was matched with three to four controls for gender, age ± 5 years and simplified acute physiology score II (SAPS II) ± 5 points. Abundant microaspiration was defined by significant levels of pepsin and alpha-amylase in >30% of tracheal aspirates. All tracheal aspirates were collected for the first 48 h of the study period. The percentage of patients with abundant gastric-content microaspiration was the primary outcome. The abundant microaspiration of oropharyngeal secretions, VAP incidence, the duration of mechanical ventilation, length of intensive care unit (ICU) stay and mortality were the secondary outcomes. A. total of 39 cirrhotic patients were matched to 138 controls. The percentage of patients with abundant gastric-content microaspiration did not differ between the two groups (relative risk: 0.91 (95% CI: 0.75 to 1.10)). There was no significant difference between the two groups in terms of the abundant microaspiration of oropharyngeal secretions, VAP, the duration of mechanical ventilation, the length of ICU stay and mortality. Our results suggest that cirrhosis is not associated with abundant gastric-content microaspiration.
Competing Interests: The authors declare no conflict of interest.
Databáze: MEDLINE
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