1. Inicio
  2. Publicaciones
  3. Lower Respiratory Tract Infection and Short-Term Outcome in Patients With Acute Respiratory Distress Syndrome.

Lower Respiratory Tract Infection and Short-Term Outcome in Patients With Acute Respiratory Distress Syndrome.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Zampieri FG
  • Povoa P
  • Salluh JI
  • Rodriguez A
  • Valade S
  • Andrade Gomes J
  • Reignier J
  • Molinos E
  • Almirall J
  • Boussekey N
  • Socias L
  • Viana WN
  • Rouze A
  • Nseir S
  • Martin-Loeches I
  • TAVeM study group

Grupos

Abstract

OBJECTIVE: To assess whether ventilator-associated lower respiratory tract infections (VA-LRTIs) are associated with mortality in critically ill patients with acute respiratory distress syndrome (ARDS). MATERIALS AND METHODS: Post hoc analysis of prospective cohort study including mechanically ventilated patients from a multicenter prospective observational study (TAVeM study); VA-LRTI was defined as either ventilator-associated tracheobronchitis (VAT) or ventilator-associated pneumonia (VAP) based on clinical criteria and microbiological confirmation. Association between intensive care unit (ICU) mortality in patients having ARDS with and without VA-LRTI was assessed through logistic regression controlling for relevant confounders. Association between VA-LRTI and duration of mechanical ventilation and ICU stay was assessed through competing risk analysis. Contribution of VA-LRTI to a mortality model over time was assessed through sequential random forest models. RESULTS: The cohort included 2960 patients of which 524 fulfilled criteria for ARDS; 21% had VA-LRTI (VAT = 10.3% and VAP = 10.7%). After controlling for illness severity and baseline health status, we could not find an association between VA-LRTI and ICU mortality (odds ratio: 1.07; 95% confidence interval: 0.62-1.83; P = .796); VA-LRTI was also not associated with prolonged ICU length of stay or duration of mechanical ventilation. The relative contribution of VA-LRTI to the random forest mortality model remained constant during time. The attributable VA-LRTI mortality for ARDS was higher than the attributable mortality for VA-LRTI alone. CONCLUSION: After controlling for relevant confounders, we could not find an association between occurrence of VA-LRTI and ICU mortality in patients with ARDS.

Datos de la publicación

ISSN/ISSNe:
0885-0666, 1525-1489

JOURNAL OF INTENSIVE CARE MEDICINE  SAGE PUBLICATIONS INC

Tipo:
Article
Páginas:
588-594
PubMed:
29699468
Factor de Impacto:
0,695 SCImago ℠
Cuartil:
Q2 SCImago ℠

Citas Recibidas en Web of Science: 14

Documentos

  • No hay documentos

Métricas

Filiaciones mostrar / ocultar

Keywords

  • acute respiratory distress syndrome; critical care; ventilator-associated pneumonia

Cita

Compartir