The association of cardiovascular failure with treatment for ventilator-associated lower respiratory tract infection
| Autor: | Fernando Zampieri, Ali AIT HSSAIN, Prof. Ignacio Martin-loeches, Angel Estella, Francois Philippart, Erika Parmentier-Decrucq, Philippe Seguin, Sebastien Preau, Antonia Socias Mir, Pierre Pasquier, Carmen Lab, Miguel Ferrer, Team3 Carmen |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty VAT VA-LRTI Critical Care and Intensive Care Medicine Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Anesthesiology Lower respiratory tract infection Intensive care Humans Medicine Risk factor Prospective cohort study Respiratory Tract Infections Aged Antibiotic stewardship SEPSIS Respiratory tract infections business.industry Pneumonia Ventilator-Associated 030208 emergency & critical care medicine Pneumonia Middle Aged medicine.disease Anti-Bacterial Agents respiratory tract diseases 030228 respiratory system Cardiovascular Diseases Propensity score matching VAP Female business |
| Zdroj: | Martin-Loeches, I, Torres, A, Povoa, P, Zampieri, F G, Salluh, J, Nseir, S, Ferrer, M, Rodriguez, A & TAVeM study Group 2019, ' The association of cardiovascular failure with treatment for ventilator-associated lower respiratory tract infection ', Intensive Care Medicine, vol. 45, no. 12, pp. 1753-1762 . https://doi.org/10.1007/s00134-019-05797-6 |
| ISSN: | 1432-1238 0342-4642 |
| Popis: | PURPOSE: Ventilator associated-lower respiratory tract infections (VA-LRTIs), either ventilator-associated pneumonia (VAP) or tracheobronchitis (VAT), accounts for most nosocomial infections in intensive care units (ICU) including. Our aim was to determine if appropriate antibiotic treatment in patients with VA-LRTI will effectively reduce mortality in patients who had cardiovascular failure.METHODS: This was a pre-planned subanalysis of a large prospective cohort of mechanically ventilated patients for at least 48 h in eight countries in two continents. Patients with a modified Sequential Organ Failure Assessment (mSOFA) cardiovascular score of 4 (at the time of VA-LRTI diagnosis and needed be present for at least 12 h) were defined as having cardiovascular failure.RESULTS: VA-LRTI occurred in 689 (23.2%) out of 2960 patients and 174 (25.3%) developed cardiovascular failure. Patients with cardiovascular failure had significantly higher ICU mortality than those without (58% vs. 26.8%; p CONCLUSIONS: Patients with VA-LRTI and cardiovascular failure did not show an association to a higher ICU survival with appropriate antibiotic treatment. Additionally, we found that in patients without cardiovascular failure, appropriate antibiotic treatment conferred a survival benefit for patients only with VAP.TRIAL REGISTRY: ClinicalTrials.gov, number NCT01791530. |
| Databáze: | OpenAIRE |
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