Pulmonary infections prime the development of subsequent ICU-acquired pneumonia in septic shock

Autor:	Jérôme Lambert, Matthieu Jamme, Charles de Roquetaillade, Jean-Paul Mira, Frédéric Pène, Jean-Daniel Chiche, Alain Cariou, Julien Charpentier, Aïcha Gassama, Jean-François Llitjos
Jazyk:	angličtina
Rok vydání:	2019
Předmět:	medicine.medical_specialty health care facilities manpower and services Critical Care and Intensive Care Medicine law.invention 03 medical and health sciences 0302 clinical medicine Nosocomial infection law Septic shock medicine Risk factor First episode Proportional hazards model business.industry Incidence (epidemiology) Research lcsh:Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine Retrospective cohort study lcsh:RC86-88.9 medicine.disease Intensive care unit Pneumonia 030228 respiratory system Emergency medicine Ventilator-acquired pneumonia business Immunosuppression
Zdroj:	Annals of Intensive Care, Vol 9, Iss 1, Pp 1-9 (2019) Annals of Intensive Care
ISSN:	2110-5820
DOI:	10.1186/s13613-019-0515-x
Popis:	Purpose To investigate the determinants and the prognosis of intensive care unit (ICU)-acquired pneumonia in patients with septic shock. Methods This single-center retrospective study was conducted in a medical ICU in a tertiary care center from January 2008 to December 2016. All consecutive patients diagnosed for septic shock within the first 48 h of ICU admission were included. Patients were classified in three groups: no ICU-acquired infections (no ICU-AI), ICU-acquired pneumonia and non-pulmonary ICU-AI. The determinants of ICU-acquired pneumonia and death were investigated by multivariate competitive risk analysis. Results A total of 1021 patients were admitted for septic shock, and 797 patients were alive in the ICU after 48 h of management. The incidence of a first episode of ICU-AI was 31%, distributed into pulmonary (17%) and non-pulmonary ICU-AI (14%). Patients with septic shock caused by pneumonia were at increased risk of further pulmonary ICU-AI with a cumulated incidence of 34.4%. A pulmonary source of the initial septic shock was an independent risk factor for subsequent ICU-acquired pneumonia (cause-specific hazard 2.33, 95% confidence interval [1.55–3.52], p
Databáze:	OpenAIRE
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