Lower respiratory tract infections following cardiac arrest and cardiopulmonary resuscitation

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Normothermic Cardiac Arrest and Cardiopulmonary Resuscitation: A Mouse Model of Ischemia-Reperfusion Injury
10:25

Normothermic Cardiac Arrest and Cardiopulmonary Resuscitation: A Mouse Model of Ischemia-Reperfusion Injury

Published on: August 30, 2011

J Rello1, J Vallés, P Jubert

  • 1Intensive Care Department, Hospital de Sabadell, Barcelona, Spain.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 1, 1995
PubMed

Insights

Pneumonia is a frequent complication for cardiac arrest survivors, affecting 24% of patients. While common, this lower respiratory tract infection has a minimal impact on patient outcomes with appropriate treatment.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pulmonology

Background:

  • Patients surviving cardiac arrest are at risk for secondary infections.
  • Lower respiratory tract infections (LRTIs) are a significant concern in this vulnerable population.

Purpose of the Study:

  • To prospectively investigate the incidence and characteristics of pneumonia in patients surviving cardiac arrest.
  • To identify common pathogens and their association with clinical factors and outcomes.

Main Methods:

  • Prospective study of 96 patients surviving >24 hours after cardiac arrest over 18 months.
  • Monitoring for and diagnosis of lower respiratory tract infections, including pneumonia and purulent tracheobronchitis.
  • Microbiological analysis to identify causative agents of pneumonia.

Main Results:

  • Pneumonia developed in 23% of patients, with a cumulative incidence of 28.1% including superinfections.
  • Gram-positive cocci, particularly Staphylococcus aureus, were the most common pathogens.
  • Pseudomonas aeruginosa was frequently isolated in patients with prior antibiotic use.
  • Mortality was higher in the pneumonia group (39.1%), but pneumonia was directly linked to only one death.

Conclusions:

  • Pneumonia is a common complication in cardiac arrest survivors but has a marginal impact on mortality with adequate treatment.
  • Gram-positive cocci are the predominant pathogens.
  • Consider Pseudomonas aeruginosa in patients with a history of antibiotic use.

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