Antibiotics (Jan 2023)

Infection-Related Ventilator-Associated Complications in Critically Ill Patients with Trauma: A Retrospective Analysis

  • Emanuele Russo,
  • Marta Velia Antonini,
  • Andrea Sica,
  • Cristian Dell’Amore,
  • Costanza Martino,
  • Emiliano Gamberini,
  • Luca Bissoni,
  • Alessandro Circelli,
  • Giuliano Bolondi,
  • Domenico Pietro Santonastaso,
  • Francesco Cristini,
  • Luigi Raumer,
  • Fausto Catena,
  • Vanni Agnoletti

DOI
https://doi.org/10.3390/antibiotics12010176
Journal volume & issue
Vol. 12, no. 1
p. 176

Abstract

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Background: Trauma is a leading cause of death and disability. Patients with trauma undergoing invasive mechanical ventilation (IMV) are at risk for ventilator-associated events (VAEs) potentially associated with a longer duration of IMV and increased stay in the intensive care unit (ICU). Methods: We conducted a retrospective cohort study aimed to evaluate the incidence of infection-related ventilator-associated complications (IVACs), possible ventilator-associated pneumonia (PVAP), and their characteristics among patients experiencing severe trauma that required ICU admission and IMV for at least four days. We also determined pathogens implicated in PVAP episodes and characterized the use of antimicrobial therapy. Results: In total, 88 adult patients were included in the main analysis. In this study, we observed that 29.5% of patients developed a respiratory infection during ICU stay. Among them, five patients (19.2%) suffered from respiratory infections due to multi-drug resistant bacteria. Patients who developed IVAC/PVAP presented lower total GCS (median value, 7; (IQR, 9) vs. 12.5, (IQR, 8); p = 0.068) than those who did not develop IVAC/PVAP. Conclusions: We observed that less than one-third of trauma patients fulfilling criteria for ventilator associated events developed a respiratory infection during the ICU stay.

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