Pulmonary infection in traumatic brain injury patients undergoing tracheostomy: predicators and nursing care

Abstract

Background Pulmonary infection is common yet serious complication in patients with severe traumatic brain injury (STBI). We aimed to evaluate the predicators of pulmonary infection in STBI patients undergoing tracheostomy, to provide evidence for the clinical nursing care of STBI patients. Methods This study was a retrospective cohort design. STBI patients undergoing tracheostomy treatment from January 1, 2019 to August 31, 2021 in our hospital were included. The characteristics of pulmonary infection and no pulmonary infection patients were analyzed. Results A total 216 STBI patients undergoing tracheostomy were included, the incidence of pulmonary infection was 26.85%. Diabetes (r = 0.782), hypoproteinemia (r = 0.804), duration of coma(r = 0.672), duration of mechanical ventilation(r = 0.724) and length of hospital stay (r = 0.655), length of hospital stay post tracheostomy (r = 0.554), mortality (r = 0.598) were all correlated with pulmonary infection (all p < 0.05). Klebsiella pneumoniae (33.87%) and Staphylococcus aureus (29.03%) were the most commonly seen pathogens in the pulmonary infection of TBI patients. Logistic regression analyses indicated that diabetes (OR 2.232, 95% CI 1.215–3.904), hypoproteinemia with plasma total protein < 60 g/L (OR 1.922, 95% CI 1.083–3.031), duration of coma ≥ 22 h (OR 2.864, 95% CI 1.344–5.012), duration of mechanical ventilation ≥ 5 days (OR 3.602, 95% CI 1.297–5.626), length of hospital stay ≥ 21 days (OR 2.048, 95% CI 1.022–3.859) were the risk factors of pulmonary infection in TBI patients undergoing tracheostomy (all p < 0.05). Conclusions Further investigations on the early preventions and treatments targeted on those risk factors are needed to reduce the pulmonary infection in clinical practice.

A nomogram for predicting the necessity of tracheostomy after severe acute brain injury in patients within the neurosurgery intensive care unit: A retrospective cohort study

“…This study proposed a clinical nomogram involving both clinical features and biomarkers to provide personalized evaluations for the necessity of TT among SABI patients in NSICUs. Although previous studies have discussed whether pneumonia was a predictor for TT [ 28 , 43 ], our results suggest that it did not play a significant role. Our model may aid clinicians in categorizing NSICU patients, facilitating early identification of high-risk TT cases and endorsing proactive and tailored treatments.…”

Modelling lung infection with Klebsiella pneumoniae after murine traumatic brain injury

“…As an opportunistic bacterium of the Enterobacteriaceae family, K. pneumoniae is a leading cause of ventilator-acquired pneumonia, urinary tract infections, and sepsis in immunocompromised and critically-ill individuals, including patients with brain injuries [ 19 , 21 , 62 ]. Indeed, recent studies of TBI patients in Taiwan and Saudi Arabia reported K. pneumoniae to be among the most prevalent pathogen in pulmonary infections [ 20 , 63 ]. There is thus a clear need to better understand the consequences of K. pneumoniae infection in the context of TBI.…”

Prevalence of Traumatic Brain Injury and Associated Infections in a Trauma Center in Northern India

“…The incidence of VAP was reported as 61.11% (44/72) in our study which is much higher in comparison to a study by Zhang et al . [ 22 ] reporting pulmonary infections in 26.85% of patients. Our observation of predominant isolation of GNB from respiratory samples of TBI patients with VAP corroborated with a study by Zhang et al .…”

“…Our observation of predominant isolation of GNB from respiratory samples of TBI patients with VAP corroborated with a study by Zhang et al . [ 22 ] Acinetobacter spp. is an emerging pathogen in most infections occurring in TBI patients and was reported as the most common microorganism causing VAP in trauma patients in a recent study by Kaur et al .…”