Risk Factors of Pneumonia Associated with Mechanical Ventilation

Abstract

Background: The hospitalization of patients treated in the intensive care unit (ICU) in 5-15% of cases is associated with the occurrence of a complication in the form of ventilator-associated pneumonia (VAP). Purpose: Retrospective assessment of risk factors of VAP in patients treated at ICUs in the University Hospital in Krakow. Methods: The research involved the medical documentation of 1872 patients treated at the ICU of the University Hospital in Krakow between 2014 and 2017. The patients were mechanically ventilated for at least 48 h. The obtained data were presented by qualitative and quantitative analysis (%). The qualitative variables were compared using the Chi 2 test. Statistically significant was the p < 0.05 value. Results: VAP was demonstrated in 23% of all patients treated in ICU during the analyzed period, and this infection occurred in 13% of men and 10% of women. Pneumonia associated with ventilation was found primarily in patients staying in the ward for over 15 days and subjected to intratracheal intubation (17%). A statistically significant was found between VAP and co-morbidities, e.g., chronic obstructive pulmonary disease, diabetes, alcoholism, obesity, the occurrence of VAP and multi-organ trauma, hemorrhage/hemorrhagic shock, and fractures as the reasons for admitting ICU patients. Conclusions: Patients with comorbidities such as chronic obstructive pulmonary disease, obesity, diabetes, and alcoholism are a high-risk group for VAP. Particular attention should be paid to patients admitted to the ICU with multi-organ trauma, fractures, and hemorrhage/hemorrhagic shock as patients predisposed to VAP. There is a need for further research into risk factors for non-modifiable VAP such as comorbidities and reasons for ICU admission in order to allow closer monitoring of these patients for VAP.

Ventilator-Associated Pneumonia in Patients with COVID-19: A Systematic Review and Meta-Analysis

“…The main finding of this systematic review and meta-analysis was that nearly one patient with COVID-19 out of two may develop VAP during ICU stay. Previous reports showed that VAP occurs in up to 23–40% of patients admitted to ICU [ 2 , 34 ], with variability usually attributable to differences regarding the clinical setting (e.g., countries, staffing), the population of patients (e.g., the reasons for admission, the severity of underlying disease) [ 35 ] or the criteria used to define VAP [ 7 ]. A higher occurrence in COVID-19 patients in comparison with patients without COVID-19 was also observed in our sensitivity analysis (OR 3.24; 95% C.I.…”

The risk factors for the postoperative pulmonary infection in patients with hypertensive cerebral hemorrhage

“…Previous studies [ 43 , 44 ] have confirmed that the subglottic secretion drainage is beneficial to combating the pulmonary infection. Study [ 45 ] has shown that pulmonary infections are prone to occur after mechanical ventilation, mainly because the bacteria that adhere to the upper respiratory tract and it can be blown to the lower respiratory tract by tracheal tube. When using the ventilator, it should be noted that the ventilator tube should be replaced and disinfected regularly to avoid breeding bacteria, and the gas should be completely humidified, this will reduce the bacterial blow-in and airway mucosal damage to a certain extent, thereby reducing incidence of pulmonary infections.…”

Analysis of Pneumonia Occurrence in Relation to Climate Change in Tanga, Tanzania

“…Studies have shown that pneumonia can be spread in a number of ways, including either through the blood shortly after a child is born, or through the air from droplets of sneezing or coughing or through air pollution [ 1 , 9 , 10 ]. Several risk factors have also been found to contribute to the occurrence of pneumonia, such as the environmental factors [ 11 , 12 , 13 , 14 ], being on a ventilator or hospitalization, chronic diseases (i.e., lung disease, chronic obstructive pulmonary disease, or asthma), a weak immune system, and other comorbidities [ 15 , 16 , 17 , 18 ]. Of great importance to this study is the effect environmental factors on pneumonia occurrence.…”