Pulmonary Infections in ICU Patients without Underlying Disease on Ventilators

Abstract

Background:At present, the use of ventilator support is an important part of treatment in ICU patients. However, aside from its well-known advantages, the use of these devices is also associated with complications, the most important of which is pulmonary infection (PI). PI has a high rate of morbidity and mortality.Objectives:This study aimed to evaluate the prevalence of PI in mechanically-ventilated patients and the role that factors, such as age, sex, and duration of intubation, play in this regard.Materials and Methods:This descriptive cross-sectional study evaluated the prevalence of PI in mechanically ventilated patients, with no underlying condition which could compromise their immune system. Age, sex, and duration of intubation were assessed. Data were analyzed using SPSS (version 16) software.Results:A total of 37 ICU patients on ventilators were evaluated, including 21 males (56.8%) and 16 females (43.2%). The mean age of the patients was 54 ± 19 years (range 19 to 86 years), with a mean age of 52 ± 20 years in men, and 56 ± 18 years in women (P = 0.52). The mean duration of ventilation was 6 ± 4 days (range 2 to 20 days). The mean duration of ventilation was 5 ± 2 days in men, and 6 ± 5 days in women (P = 0.42). A total of 16 patients (43.2%) developed ventilator-associated pneumonia (VAP); of whom, 50% were male and 50% female (P = 0.46). Patients who developed a pulmonary infection had a significantly longer duration of ventilation. The mean duration of ventilation was 8 ± 4 days in patients who had developed VAP, while this duration was 4 ± 2 days in the non-affected patients (P = 0.005). Overall, 17 patients died, and 7 of these deaths were attributed to VAP.Conclusions:The prevalence of VAP in this study was approximately 43%, which is relatively high. In total, the percentage of deaths due to VAP among the patients was 18.91%. Duration of ventilator support was significantly correlated with the prevalence of PI.

Risk factors for 28-day mortality in patients with sepsis-related myocardial injury in intensive care units

“…Pulmonary infection, possibly due to a high rate of mechanical ventilation, 14 is the most common and major cause of sepsis in patients in the ICU. Caraballo et al.…”

“…Sepsis-related myocardial injury is not only limited to heart tissue, but also affects systemic hemodynamics and has fluid resuscitation effects, 13 which significantly affect the short-term and long-term prognosis of patients. 10 Pulmonary infection, possibly due to a high rate of mechanical ventilation, 14 is the most common and major cause of sepsis in patients in the ICU. Caraballo et al 15 showed a significant correlation between pulmonary infection and hospital mortality in patients with sepsis (OR: 3.4, 95% CI: 2.2-5.5).…”

Mesenchymal stromal cells and alpha-1 antitrypsin have a strong synergy in modulating inflammation and its resolution

“…For hyperinflammation, immune cells become excessive and hyperactive, producing sustained and large quantities of cytokines that cause elevated circulating levels, leading to systemic immune cell activation and cytokine production (i.e., cytokine storm) 1 . The systemic inflammation can rapidly progress to disseminated intravascular coagulation, endothelium damage, capillary leakage, multiorgan (e.g., liver, kidney, heart, and brain) dysfunction, ARDS, and fatality 11,12 . Although the initial driver may differ, the late-stage clinical features of hyperinflammation and cytokine storm converge.…”

“…However, under certain conditions, such as an overwhelming pathogen burden, immune cell activation and cytokine production become dysregulated, excessive, persistent, and systemic (i.e., cytokine storm) 1 . Hyperinflammation can rapidly progress to disseminated intravascular coagulation, vascular leakage, acute respiratory distress syndrome (ARDS), multi-organ dysfunction (MODS), and death 11,12 .…”

Protective effect of interleukin-10 and recombinant human keratinocyte growth factor-2 on ventilation-induced lung injury in rats

“…Mechanical ventilation (MV), a basic life support method used during anesthesia, plays a key role in the treatment of critical patients, especially those with acute lung injuries and acute respiratory distress syndrome (Ghanbarpour et al, 2014;Tsushima and Tatsumi, 2014). MV has both positive and negative effects in the field of anesthesia medicine; MV improves the functions of critical organs, including the heart, brain, liver, and kidney, thereby stabilizing the inner environment of the body and facilitating patient recovery.…”