Related Experiment Videos

The impact of COPD on ICU mortality in patients with ventilator-associated pneumonia

Demosthenes Makris1, Benoit Desrousseaux, Epaminondas Zakynthinos

  • 1Intensive Care Unit, Calmette Hospital, University Hospital of Lille, boulevard du Pr Leclercq, 59037 Lille cedex, France. appollon7@hotmail.com

Respiratory Medicine
|March 26, 2011
PubMed
Abstract

Insights

Patients with Chronic Obstructive Pulmonary Disease (COPD) have higher intensive care unit (ICU) mortality when diagnosed with Ventilator-Associated Pneumonia (VAP). COPD is an independent risk factor for VAP mortality.

Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Infectious Diseases

Background:

  • Ventilator-Associated Pneumonia (VAP) is a significant cause of morbidity and mortality in intensive care units (ICUs).
  • Chronic Obstructive Pulmonary Disease (COPD) is a prevalent condition that may influence patient outcomes in critical illness.

Purpose of the Study:

  • To investigate the impact of COPD on ICU mortality among patients diagnosed with VAP.
  • To identify risk factors associated with ICU mortality in VAP patients.

Main Methods:

  • Prospective observational study conducted in a mixed ICU over 3 years.
  • Included patients with mechanical ventilation for >48 hours and microbiologically confirmed VAP.
  • Univariate and multivariable analyses were used to determine risk factors for ICU mortality.

Main Results:

  • 215 patients with VAP were analyzed; 88% had late-onset VAP, and Pseudomonas aeruginosa was the most common pathogen.
  • ICU mortality was significantly higher in COPD patients (60%) compared to non-COPD patients (43.3%).
  • COPD, SAPS II score, and shock at VAP diagnosis were independent risk factors for ICU mortality.

Conclusions:

  • COPD is independently associated with increased ICU mortality in patients with VAP.
  • SAPS II score and the presence of shock at VAP diagnosis also independently predict ICU mortality.
  • These findings highlight the importance of considering COPD status in managing VAP patients.

Related Concept Videos

Pneumonia I: Introduction01:30

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pneumonia I: Introduction01:29

Pneumonia I: Introduction

Pneumonia is an infection of the lower respiratory tract that leads to inflammation of the lung parenchyma, often resulting in the accumulation of inflammatory exudate in the alveoli and airways. Unlike the watery, low-protein fluid exudate in pulmonary edema, the exudate in this case is a thick fluid rich in immune cells, proteins, and debris produced during infection and inflammation.This impairs gas exchange and can lead to consolidation of lung tissue. The infection may be caused by a...
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Factors Affecting Pulmonary Ventilation01:19

Factors Affecting Pulmonary Ventilation

Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...