Risk Factors and Protective Factors against Ventilator-Associated Pneumonia-A Single-Center Mixed Prospective and...

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Respiratory Therapy

Background:

• Ventilator-associated pneumonia (VAP) is a significant concern in intensive care units (ICUs).
• Identifying risk and protective factors is crucial for effective VAP prevention strategies.

Purpose of the Study:

• To determine the incidence of VAP in critically ill patients.
• To identify independent risk and protective factors associated with VAP development.

Main Methods:

• A mixed prospective and retrospective cohort study involving 371 critically ill patients.
• Implementation of standard VAP prevention, including continuous automatic pressure control of endotracheal tube cuffs and continuous subglottic secretion suction in the prospective group.
• Multivariable logistic regression analysis to identify significant factors.

Main Results:

• The incidence of VAP was 14% (9.7 per 1000 ventilator days), with a median onset of 7 days.
• Tracheotomy (OR=1.6), multidrug-resistant bacteria (OR=2.73), and ICU length of stay >5 days (OR=3.32) were significantly associated with increased VAP risk.
• Combined continuous cuff pressure control and subglottic secretion suction showed a protective effect (OR=0.61).

Conclusions:

• Tracheotomy, multidrug-resistant bacteria, and prolonged ICU stay are independent risk factors for VAP.
• Simultaneous use of continuous cuff pressure control and subglottic secretion suction demonstrates a protective effect against VAP.
• These findings support targeted interventions for VAP prevention in high-risk ICU patients.