BMJ Open (May 2024)

Association between septic shock and tracheal injury score in intensive care unit patients with invasive ventilation: a prospective single-centre cohort study in China

  • Ye Tian,
  • Pei Zhang,
  • Haitao Li,
  • Long Bai,
  • Zhigang Cai,
  • Qilin Yang,
  • Chunhua Yin,
  • Huaihai Lu,
  • Liwen Li,
  • Lining Huang

DOI
https://doi.org/10.1136/bmjopen-2023-078763
Journal volume & issue
Vol. 14, no. 5

Abstract

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Objectives There was no evidence regarding the relationship between septic shock and tracheal injury scores. Investigate whether septic shock was independently associated with tracheal injury scores in intensive care unit (ICU) patients with invasive ventilation.Design Prospective observational cohort study.Setting Our study was conducted in a Class III hospital in Hebei province, China.Participants Patients over 18 years of age admitted to the ICU between 31 May 2020 and 3 May 2022 with a tracheal tube and expected to be on the tube for more than 24 hours.Primary and secondary outcome measures Tracheal injuries were evaluated by examining hyperaemia, ischaemia, ulcers and tracheal perforation by fiberoptic bronchoscope. Depending on the number of lesions, the lesions were further classified as moderate, severe or confluent.Results Among the 97 selected participants, the average age was 56.6±16.5 years, with approximately 64.9% being men. The results of adjusted linear regression showed that septic shock was associated with tracheal injury scores (β: 2.99; 95% CI 0.70 to 5.29). Subgroup analysis revealed a stronger association with a duration of intubation ≥8 days (p=0.013).Conclusion Patients with septic shock exhibit significantly higher tracheal injury scores compared with those without septic shock, suggesting that septic shock may serve as an independent risk factor for tracheal injury.Trial registration number ChiCTR2000037842, registered 03 September 2020. Retrospectively registered, https://www.chictr.org.cn/edit.aspx?pid=57011&htm=4.