Nutritional Status Disorders and Selected Risk Factors of Ventilator-Associated Pneumonia (VAP) in Patients Treated in the Intensive Care Ward—A Retrospective Study

Abstract

Introduction: The development of pneumonia in patients treated in intensive care wards is influenced by numerous factors resulting from the primary health condition and co-morbidities. The aim of this study is the determination of the correlation between nutritional status disorders and selected risk factors (type of injury, epidemiological factors, mortality risk, inflammation parameters, age, and gender) and the time of pneumonia occurrence in patients mechanically ventilated in intensive care wards. Material and method: The study included 121 patients with injuries treated in the intensive care ward who had been diagnosed with pneumonia related to mechanical ventilation. The data were collected using the method of retrospective analysis of patients’ medical records available in the electronic system. Results: Ventilator-associated pneumonia (VAP) occurred more frequently in patients over 61 years of age (40.4%), men (67.8%), after multiple-organ injury (45.5%), and those with a lower albumin level (86%), higher CRP values (83.5%), and leukocytes (68.6%). The risk of under-nutrition assessed with the NRS-2002 system was confirmed in the whole study group. The statistical analysis demonstrated a correlation between the leukocytes level (p = 0.012) and epidemiological factors (p = 0.035) and the VAP contraction time. Patients infected with Staphylococcus aureus had 4% of odds for the development of late VAP in comparison to Acinetobacter baumannii (p < 0.001), whereas patients infected by any other bacteria or fungi had about four times lower odds of the development of late VAP in comparison to Acinetobacter baumannii (p = 0.02). Patients with results in APACHE from 20 to 24 and from 25 to 29 had 13% and 21%, respectively, odds of the development of late VAP in comparison to patients with APACHE II scores ranging from 10 to 19 (respectively, p = 0.006; p = 0.028). Conclusions: The development of VAP is impacted by many factors, the monitoring of which has to be included in prophylactics and treatment.

Evaluation of a bundle approach for the prophylaxis of ventilator-associated pneumonia: A retrospective single-center Study

“…Invasive surgery for older patients and those with cerebrovascular disease may lead to prolonged intubation, even at our institution. In these cases, tracheostomy and aggressive nutritional management may reduce the occurrence of VAP (21,22). We would also like to consider tracheostomy for longterm management in future research.…”

Hospital-acquired and ventilator-associated pneumonia caused by multidrug-resistant Gram-negative pathogens: Understanding epidemiology, resistance patterns, and implications with COVID-19

“…Any further responses from the reviewers can be found at the end of the article lung disease, chronic renal failure, and thyroid disorders. 22,23 Mechanical ventilation, 24 especially if prolonged for more than two weeks, 21 reintubation or tracheostomy, 25 major chest or abdominal surgery, 26 as well as previous antibiotic exposure, especially to broad-spectrum antibiotics, 27 are possible risk factors for VAP. Of note, some studies have reported an increased incidence of HAP when the gastric pH is increased with the use of medications including H 2 receptor blockers, antacids, or proton pump inhibitors.…”

Constructing a Nomogram Model to Estimate the Risk of Ventilator-Associated Pneumonia for Elderly Patients in the Intensive Care Unit

“…Common risk factors for VAP may include sex, Acute Physiology and Chronic Health Evaluation (APACHE) II score, hypoproteinemia, state of consciousness, prior antibiotic therapy, age, intubation times, mechanical ventilation days, tracheotomy, and underlying diseases such as diabetes and chronic obstructive pulmonary disease [7][8][9][10][11]. Furthermore, previous studies have shown that oral care, bed elevation of 30-45 • , and continuing aspiration of subglottic secretions might decrease VAP risk [12][13][14].…”