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Updated: Jan 20, 2026
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Short- and long-term respiratory outcomes in neonates with ventilator-associated pneumonia
Valentina Dell'Orto1, Roberto Raschetti1, Roberta Centorrino1
1Division of Pediatrics and Neonatal Critical Care, Medical Center "A.Béclère", South Paris University Hospitals, APHP, Paris, France.
Insights
Ventilator-associated pneumonia (VAP) in neonates increases bronchopulmonary dysplasia (BPD) risk and prolongs intensive care and ventilation duration. However, VAP does not appear to impact long-term respiratory morbidity in this population.
Area of Science:
- Neonatology
- Pediatric Critical Care
- Infectious Diseases
Background:
- Ventilator-associated pneumonia (VAP) is a significant nosocomial infection in neonatal intensive care units.
- VAP may lead to adverse short- and long-term respiratory outcomes in neonates.
Purpose of the Study:
- To investigate the short- and long-term respiratory consequences of VAP in neonates.
- To clarify the association between VAP and bronchopulmonary dysplasia (BPD) and other respiratory morbidities.
Main Methods:
- Prospective, population-based cohort study with 12-month follow-up.
- Inclusion of 151 neonates requiring at least 48 hours of mechanical ventilation.
- Classification of neonates into VAP-exposed and VAP-unexposed groups.
Main Results:
- VAP-exposed neonates had a significantly higher incidence of BPD (75% vs. 26.8%).
- Exposed neonates experienced longer intensive care unit stays and duration of ventilation.
- No significant difference in long-term respiratory morbidity, rehospitalization, or home oxygen therapy between groups.
Conclusions:
- Neonatal VAP is associated with an increased risk of BPD and prolonged mechanical ventilation and ICU stay.
- VAP does not appear to negatively impact long-term respiratory morbidity in neonates.
- Early identification and prevention of VAP are crucial for improving neonatal outcomes.
Background And Objective:
Ventilator-associated pneumonia (VAP) is a common nosocomial infection in critical care settings and might have important long-term consequences in neonates. Our aim is to clarify the short- and long-term respiratory outcomes of neonates affected by VAP.
Methods:
Prospective, population-based, cohort study with 12 months follow-up based on clinical examinations and diary-based respiratory morbidity score, conducted in an academic tertiary referral neonatal unit with dedicated follow-up program.
Results:
A total of 199 inborn neonates consecutively ventilated for at least 48 hours were eligible for the study. One hundred fifty-one were finally enrolled and classified as "exposed" or "unexposed" to VAP, if they fulfilled (or not) VAP criteria once during their stay. Bronchopulmonary dysplasia (BPD) incidence was significantly higher in exposed (75%) than in unexposed babies (26.8%; relative risk [RR]: 2.8 [1.9-4.0]; Adj RR: 3.5 [1.002-12.7]; P = .049; number needed to harm = 2.07), although the composite BPD/mortality did not differ. Exposed patients showed longer intensive care unit stay (87 [43-116] vs 14 [8-52] days; St.β = 0.24; P < .0001) and duration of ventilation (15 [10-25] vs 5 [4-8] days; St.β = 0.29; P < .0001) than unexposed neonates. Exposed patients also showed less ventilator-free days (11 [5-17.7] vs 22 [14-24] days; St.β = -0.15; P = .05) compared to unexposed. Respiratory infections, use of drugs, rehospitalization for respiratory reasons, home oxygen therapy, their composite outcome, and diary-based clinical respiratory morbidity score were similar between the cohorts.
Conclusion:
Neonatal VAP seems associated to higher incidence of BPD, longer ventilation, and intensive care stay but it does not affect long-term respiratory morbidity.
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