Incidence, risk factors, and outcome of ventilator-associated pneumonia

Eva Tejerina, Fernando Frutos-Vivar, Marcos Restrepo, Antonio R Anzueto, Fekri Abroug, Fernando Palizas, Marco González, Gabriel D'Empaire, Carlos Apezteguía, Andrés Esteban

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Objective: The purpose of this study is to determine the incidence, risk factors, and outcome of ventilator-associated pneumonia (VAP). Design: Prospective cohort. Setting: Three hundred sixty-one intensive care units (ICUs) from 20 countries. Patients and Participants: Two thousand eight hundred ninety-seven patients mechanically ventilated for more than 12 hours. Measurements and Results: Baseline demographic data, primary indication for mechanical ventilation, daily ventilator settings, multiple organ failure over the course of mechanical ventilation, and outcome were collected. Ventilator-associated pneumonia was present in 439 patients (15%). Patients with VAP were more likely to have chronic pulmonary obstructive disease, aspiration, sepsis, and acute respiratory distress syndrome. Mortality in patients with VAP was 38%. Factors associated with mortality were severity of illness, limited activity before the onset of mechanical ventilation and development of shock, acute renal failure, and worsening of hypoxemia during the period of mechanical ventilation. Case-control analysis showed no increased mortality in patients with VAP (38.1% vs 37.9%, P = .95) but prolonged duration of mechanical ventilation and ICU stay. Conclusion: In a large cohort of mechanically ventilated patients, VAP is more likely in patients with underlying lung disease (acute or chronic). Ventilator-associated pneumonia was associated with a significant increase in ICU length of stay but no increase in mortality.

Original languageEnglish (US)
Pages (from-to)56-65
Number of pages10
JournalJournal of Critical Care
Volume21
Issue number1
DOIs
StatePublished - Mar 2006

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Ventilator-Associated Pneumonia
Artificial Respiration
Incidence
Intensive Care Units
Mortality
Multiple Organ Failure
Adult Respiratory Distress Syndrome
Mechanical Ventilators
Acute Kidney Injury
Chronic Obstructive Pulmonary Disease
Lung Diseases
Shock
Length of Stay
Sepsis
Demography

Keywords

  • Critical care
  • Epidemiology
  • Mechanical ventilation
  • Mortality
  • Outcome
  • Ventilator-associated pneumonia

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Incidence, risk factors, and outcome of ventilator-associated pneumonia. / Tejerina, Eva; Frutos-Vivar, Fernando; Restrepo, Marcos; Anzueto, Antonio R; Abroug, Fekri; Palizas, Fernando; González, Marco; D'Empaire, Gabriel; Apezteguía, Carlos; Esteban, Andrés.

In: Journal of Critical Care, Vol. 21, No. 1, 03.2006, p. 56-65.

Research output: Contribution to journalArticle

Tejerina, E, Frutos-Vivar, F, Restrepo, M, Anzueto, AR, Abroug, F, Palizas, F, González, M, D'Empaire, G, Apezteguía, C & Esteban, A 2006, 'Incidence, risk factors, and outcome of ventilator-associated pneumonia', Journal of Critical Care, vol. 21, no. 1, pp. 56-65. https://doi.org/10.1016/j.jcrc.2005.08.005
Tejerina, Eva ; Frutos-Vivar, Fernando ; Restrepo, Marcos ; Anzueto, Antonio R ; Abroug, Fekri ; Palizas, Fernando ; González, Marco ; D'Empaire, Gabriel ; Apezteguía, Carlos ; Esteban, Andrés. / Incidence, risk factors, and outcome of ventilator-associated pneumonia. In: Journal of Critical Care. 2006 ; Vol. 21, No. 1. pp. 56-65.
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