Factors related to death from ventilator-associated pneumonia in a university hospital: a retrospective study
Fatores relacionados ao óbito por pneumonia associada à ventilação mecânica em um hospital universitário: um estudo retrospectivo
DOI:
https://doi.org/10.53660/CLM-934-23B71Palavras-chave:
Pneumonia associada à ventilação mecânica; Unidade de cuidados intensivos; Fatores de risco; Mortalidade.Resumo
The objective of this study was to identify factors related to death in patients diagnosed with ventilator-associated pneumonia admitted to the intensive care unit of the University Hospital of Brasília. Methodology: Retrospective study, based on the analysis of the medical records of 73 patients diagnosed with ventilator-associated pneumonia, from March 2017 to December 2020. Statistical analyzes were performed using the unpaired Student's t test and the Chi test. -Pearson square. Results: The factors age, Simplified Acute Physiology III, probability of death, relative mechanical ventilation time, relative intensive care unit time and respiratory comorbidities were related to mortality in the patients studied. Conclusion: This study contributed to a better understanding of ventilator-associated pneumonia, reinforcing the need for control and epidemiological surveillance of its risk of death..
Downloads
Referências
Agência Nacional de Vigilância Sanitária ANVISA. (2017). Medidas de Prevenção de Infecção Relacionada à Assistência à Saúde. Brasília, Brasil.
Augustyn B. (2007). Ventilator-associated pneumonia: risk factors and prevention. Critical care nurse, 27(4), 32–40.
Barsanti, M. C., & Woeltje, K. F. (2009). Infection prevention in the intensive care unit. Infectious disease clinics of North America, 23(3), 703–725. https://doi.org/10.1016/j.idc.2009.04.012
Bassetti, M., Mularoni, A., Giacobbe, D. R., Castaldo, N., & Vena, A. (2022). New Antibiotics for Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia. Seminars in respiratory and critical care medicine, 43(2), 280–294. https://doi.org/10.1055/s-0041-1740605
Brown, R. T., Pierluissi, E., Guzman, D., Kessell, E. R., Goldman, L. E., Sarkar, U., Schneidermann, M., Critchfield, J. M., & Kushel, M. B. (2014). Functional disability in late-middle-aged and older adults admitted to a safety-net hospital. Journal of the American Geriatrics Society, 62(11), 2056–2063. https://doi.org/10.1111/jgs.13103
Ferrer, M., & Torres, A. (2018). Epidemiology of ICU-acquired pneumonia. Current opinion in critical care, 24(5), 325–331. https://doi.org/10.1097/MCC.0000000000000536
Campos, C. G. P., Pacheco, A., Gaspar, M. D. D. R., Arcaro, G., Reche, P. M., Nadal, J. M., & Farago, P. V. (2021). Analysis of diagnostic criteria for ventilator-associated pneumonia: a cohort study. Revista brasileira de enfermagem, 74(6), e20190653. https://doi.org/10.1590/0034-7167-2019-0653
Chastre, J., & Fagon, J. Y. (2002). Ventilator-associated pneumonia. American journal of respiratory and critical care medicine, 165(7), 867–903. https://doi.org/10.1164/ajrccm.165.7.2105078
Cornistein, Wanda, Colque, Ángel M, Staneloni, María Inés, Lloria, María Monserrat, Lares, Mónica, González, Ana Laura, Fernández Garcés, Alejandro, & Carbone, Edith. (2018). Neumonía asociada a ventilación mecánica: Actualización y recomendaciones inter-sociedades, Sociedad Argentina de infectología - Sociedad Argentina de terapia intensiva. Medicina (Buenos Aires), 78(2), 99-106.
de-Miguel-Diez, J., Jimenez-Garcia, R., Hernandez-Barrera, V., de-Miguel-Yanes, J. M., Carabantes-Alarcon, D., & Lopez-de-Andres, A. (2021). Assessing the Impact of Gender and COPD on the Incidence and Mortality of Hospital-Acquired Pneumonia. A Retrospective Cohort Study Using the Spanish National Discharge Database (2016-2019). Journal of clinical medicine, 10(22), 5453. https://doi.org/10.3390/jcm10225453
François, B., Cariou, A., Clere-Jehl, R., Dequin, P. F., Renon-Carron, F., Daix, T., Guitton, C., Deye, N., Legriel, S., Plantefève, G., Quenot, J. P., Desachy, A., Kamel, T., Bedon-Carte, S., Diehl, J. L., Chudeau, N., Karam, E., Durand-Zaleski, I., Giraudeau, B., Vignon, P., … CRICS-TRIGGERSEP Network and the ANTHARTIC Study Group (2019). Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest. The New England journal of medicine, 381(19), 1831–1842. https://doi.org/10.1056/NEJMoa1812379
Hellyer, T. P., Ewan, V., Wilson, P., & Simpson, A. J. (2016). The Intensive Care Society recommended bundle of interventions for the prevention of ventilator-associated pneumonia. Journal of the Intensive Care Society, 17(3), 238–243. https://doi.org/10.1177/1751143716644461
Janssens, J. P., & Krause, K. H. (2004). Pneumonia in the very old. The Lancet. Infectious diseases, 4(2), 112–124. https://doi.org/10.1016/S1473-3099(04)00931-4
Joseph, N. M., Sistla, S., Dutta, T. K., Badhe, A. S., & Parija, S. C. (2010). Ventilator-associated pneumonia: role of colonizers and value of routine endotracheal aspirate cultures. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 14(8), e723–e729. https://doi.org/10.1016/j.ijid.2010.02.2248
Kalil, A. C., Metersky, M. L., Klompas, M., Muscedere, J., Sweeney, D. A., Palmer, L. B., Napolitano, L. M., O'Grady, N. P., Bartlett, J. G., Carratalà, J., El Solh, A. A., Ewig, S., Fey, P. D., File, T. M., Jr, Restrepo, M. I., Roberts, J. A., Waterer, G. W., Cruse, P., Knight, S. L., & Brozek, J. L. (2016). Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 63(5), e61–e111. https://doi.org/10.1093/cid/ciw353
Kallet R. H. (2019). Ventilator Bundles in Transition: From Prevention of Ventilator-Associated Pneumonia to Prevention of Ventilator-Associated Events. Respiratory care, 64(8), 994–1006. https://doi.org/10.4187/respcare.06966
Koulenti, D., Parisella, F. R., Xu, E., Lipman, J., & Rello, J. (2019). The relationship between ventilator-associated pneumonia and chronic obstructive pulmonary disease: what is the current evidence?. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 38(4), 637–647. https://doi.org/10.1007/s10096-019-03486-2
Leone, M., Bouadma, L., Bouhemad, B., Brissaud, O., Dauger, S., Gibot, S., Hraiech, S., Jung, B., Kipnis, E., Launey, Y., Luyt, C. E., Margetis, D., Michel, F., Mokart, D., Montravers, P., Monsel, A., Nseir, S., Pugin, J., Roquilly, A., Velly, L., … GFRUP (2018). Brief summary of French guidelines for the prevention, diagnosis and treatment of hospital-acquired pneumonia in ICU. Annals of intensive care, 8(1), 104. https://doi.org/10.1186/s13613-018-0444-0
Li, Y., Liu, C., Xiao, W., Song, T., & Wang, S. (2020). Incidence, Risk Factors, and Outcomes of Ventilator-Associated Pneumonia in Traumatic Brain Injury: A Meta-analysis. Neurocritical care, 32(1), 272–285. https://doi.org/10.1007/s12028-019-00773-w
Maran, Edilaine, Spigolon, Dandara Novakowski, Matsuda, Laura Misue, Teston, Elen Ferraz, Oliveira, João Lucas Campos de, Souza, Verusca Soares de, & Marcon, Sonia Silva. (2021). Efeitos da utilização do bundle na prevenção de pneumonia associada à ventilação mecânica: revisão integrativa. Revista Cuidarte, 12(1), e1110. Epub May 19, 2021. https://doi.org/10.15649/cuidarte.1110
Melsen, W. G., Rovers, M. M., & Bonten, M. J. (2009). Ventilator-associated pneumonia and mortality: a systematic review of observational studies. Critical care medicine, 37(10), 2709–2718. https://doi.org/10.1097/ccm.0b013e3181ab8655
Montini, G. R., Mestrinari, A. C. R., Rodrigues, A. M. D. S., Contrin, L. M., Werneck, A. L., & Beccaria, L. M. (2020). Adesão ao bundle para prevenção de pneumonia associada à ventilação mecânica em terapia intensiva. Cuid Arte, Enferm, 172-180.
Moralez, G. M., Rabello, L. S. C. F., Lisboa, T. C., Lima, M. D. F. A., Hatum, R. M., De Marco, F. V. C., Alves, A., Pinto, J. E. D. S. S., de Araújo, H. B. N., Ramos, G. V., Silva, A. R., Fernandes, G. C., Faria, G. B. A., Mendes, C. L., Ramos Filho, R. Á., de Souza, V. P., do Brasil, P. E. A. A., Bozza, F. A., Salluh, J. I. F., Soares, M., … ORCHESTRA Study Investigators (2017). External validation of SAPS 3 and MPM0-III scores in 48,816 patients from 72 Brazilian ICUs. Annals of intensive care, 7(1), 53. https://doi.org/10.1186/s13613-017-0276-3
Muscedere, J. G., Day, A., & Heyland, D. K. (2010). Mortality, attributable mortality, and clinical events as end points for clinical trials of ventilator-associated pneumonia and hospital-acquired pneumonia. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 51 Suppl 1, S120–S125. https://doi.org/10.1086/653060
Núñez, S. A., Roveda, G., Zárate, M. S., Emmerich, M., & Verón, M. T. (2021). Ventilator-associated pneumonia in patients on prolonged mechanical ventilation: description, risk factors for mortality, and performance of the SOFA score. Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia, 47(3), e20200569. https://doi.org/10.36416/1806-3756/e20200569
Osti, C., Wosti, D., Pandey, B., & Zhao, Q. (2017). Ventilator-Associated Pneumonia and Role of Nurses in Its Prevention. JNMA; journal of the Nepal Medical Association, 56(208), 461–468.
Papazian, L., Klompas, M., & Luyt, C. E. (2020). Ventilator-associated pneumonia in adults: a narrative review. Intensive care medicine, 46(5), 888–906. https://doi.org/10.1007/s00134-020-05980-0
Rello, J., Jubert, P., Vallés, J., Artigas, A., Rué, M., & Niederman, M. S. (1996). Evaluation of outcome for intubated patients with pneumonia due to Pseudomonas aeruginosa. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 23(5), 973–978. https://doi.org/10.1093/clinids/23.5.973
Rouzé, A., Cottereau, A., & Nseir, S. (2014). Chronic obstructive pulmonary disease and the risk for ventilator-associated pneumonia. Current opinion in critical care, 20(5), 525–531. https://doi.org/10.1097/MCC.0000000000000123
Sistema de Informação sobre Mortalidade/Ministério da Saúde, Estatísticas de Pneumonia Associada à ventilação Mecânica, SIM/MS 2022.
Sociedade Paulista de Infectologia. Diretrizes sobre pneumonia associada à ventilação mecânica (PAV), 2006.
Stoclin, A., Rotolo, F., Hicheri, Y., Mons, M., Chachaty, E., Gachot, B., Pignon, J. P., Wartelle, M., & Blot, F. (2020). Ventilator-associated pneumonia and bloodstream infections in intensive care unit cancer patients: a retrospective 12-year study on 3388 prospectively monitored patients. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 28(1), 193–200. https://doi.org/10.1007/s00520-019-04800-6
Tejerina, E., Frutos-Vivar, F., Restrepo, M. I., Anzueto, A., Abroug, F., Palizas, F., González, M., D'Empaire, G., Apezteguía, C., Esteban, A., & Internacional Mechanical Ventilation Study Group (2006). Incidence, risk factors, and outcome of ventilator-associated pneumonia. Journal of critical care, 21(1), 56–65. https://doi.org/10.1016/j.jcrc.2005.08.005
Wunderink, R. G., Roquilly, A., Croce, M., Rodriguez Gonzalez, D., Fujimi, S., Butterton, J. R., Broyde, N., Popejoy, M. W., Kim, J. Y., & De Anda, C. (2021). A Phase 3, Randomized, Double-Blind Study Comparing Tedizolid Phosphate and Linezolid for Treatment of Ventilated Gram-Positive Hospital-Acquired or Ventilator-Associated Bacterial Pneumonia. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 73(3), e710–e718. https://doi.org/10.1093/cid/ciab032
