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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
04:32

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia

Published on: June 28, 2018

Dose-dependent association between opioid administration and ventilator-associated pneumonia in sepsis patients

Shengwei Lin1, Lidan Chi1, Wenbin Lu1

  • 1Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, 200433, China.

Respiratory Medicine
|June 15, 2026
PubMed
Abstract

Insights

High opioid doses in mechanically ventilated patients significantly increase the risk of ventilator-associated pneumonia (VAP). This association also linked to higher rates of acute kidney injury and 30-day mortality, underscoring the need for cautious opioid management.

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Infectious Diseases

Background:

  • Ventilator-associated pneumonia (VAP) is a significant concern in intensive care units (ICUs).
  • Opioid administration is common in mechanically ventilated (MV) patients.

Purpose of the Study:

  • To investigate the association between opioid administration and VAP risk in MV patients.
  • To explore the impact of opioid dosing on secondary outcomes like acute kidney injury (AKI) and mortality.

Main Methods:

  • Retrospective cohort study using the MIMIC-IV database.
  • Identified VAP using ICD codes.
  • Employed logistic regression and propensity score matching to analyze opioid exposure and VAP risk.

Main Results:

  • Higher opioid doses (fentanyl equivalent daily dose >2.47 mg/day) were associated with a significantly increased risk of VAP (OR: 2.12).
  • This association persisted after propensity score matching (OR: 1.86).
  • High opioid use also correlated with increased AKI risk (OR: 1.54) and higher 30-day mortality (HR: 2.65).

Conclusions:

  • Opioid administration is significantly associated with increased VAP risk in critically ill MV patients.
  • Specific comorbidities may influence this association.
  • Careful opioid dosing strategies are crucial for managing MV patients to mitigate VAP and other adverse outcomes.
Keywords:
Analgesia administrationMechanical ventilationOpioidSepsisVentilator-associated pneumonia

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