Risk factors for ventilator-associated pneumonia in trauma patients with torso injury: a retrospective single-center study

Abstract

Objective We aimed to identify the risk factors for ventilator-associated pneumonia in patients admitted to critical care after a torso injury. Methods We retrospectively evaluated 178 patients with torso injury aged >15 years who were intubated in the emergency room and placed on a mechanical ventilator after intensive care unit (ICU) admission, survived for >48 hours, had thoracic and/or abdominal injuries, and had no end-stage renal disease. We compared clinico-laboratory variables between ventilator-associated pneumonia (n = 54, 30.3%) and non-ventilator-associated pneumonia (n = 124, 69.7%) groups. Risk factors for ventilator-associated pneumonia were assessed using multivariable logistic regression analysis. Results Ventilator-associated pneumonia was associated with a significantly longer stay in the ICU (11.3 vs. 6.8 days) and longer duration of mechanical ventilation (7 vs. 3 days). Injury Severity Score (adjusted odds ratio [AOR]: 1.048; 95% confidence interval [CI]: 1.008–1.090), use of vasopressors (AOR: 2.541; 95% CI: 1.121–5.758), and insertion of a nasogastric tube (AOR: 6.749; 95% CI: 2.397–18.999) were identified as independent risk factors of ventilator-associated pneumonia. Conclusion Ventilator-associated pneumonia in patients with torso injury who were admitted to the ICU was highly correlated with Injury Severity Score, use of vasopressors, and insertion of a nasogastric tube.

Hydrogen Attenuates Cognitive Impairment in Rat Models of Vascular Dementia by Inhibiting Oxidative Stress and NLRP3 Inflammasome Activation

“…The authors hypothesized that the two mechanisms by which hydrogen exerts its anti-inflammatory effects are activation of the anti-apoptotic system through the inhibition of ROS activity and direct modulation of inflammation through regulatory T cells (Tregs) involved in the regulation of autoimmunity and suppression. [38] NLRP3 inflammasomes are also an important pathway for the regulation of apoptosis in organisms, and the results of our study are consistent with this hypothesis. However, the exact mechanism underlying the anti-inflammatory effect of H 2 remains unclear, and more in-depth mechanistic studies are needed in the future.…”

The establishment and validation of a prediction model for traumatic intracranial injury patients: a reliable nomogram

“…Compared to patients who did not have hospital-acquired pneumonia, those with hospital-acquired pneumonia had worse outcomes and experienced elevated intracranial pressure ( 4 ). There was a significant association between ventilator-associated pneumonia, prolonged ICU stays, and mechanical ventilation durations ( 22 ). A prospective observational study by Chiara Robba et al included TBI ICU patients from multi centers in Europe and found an association between an increased risk of VAP and a high risk for respiratory failure in the ICU.…”

“…Other risk factors include age, younger alcohol abuse, drug abuse, thoracic trauma, chest trauma, histamine-receptor antagonist intake, and antibiotic prophylaxis ( 23 ). Compared to non-trauma patients, intubated patients in ICU with trauma had a four times higher VAP incidence rate ( 22 ).…”

Risk Factors and Protective Factors against Ventilator-Associated Pneumonia—A Single-Center Mixed Prospective and Retrospective Cohort Study

“…In their study, Xu et al [12] also indicated the following risk factors: the number of central venous catheters, the duration of maintaining the catheter in the urinary bladder, the number of antibiotics administered, and the use of corticosteroids before mechanical ventilation. In the research conducted by Lee et al [13], VAP was strongly correlated with the severity of an injury, the use of vasopressors and the insertion of a nasogastric tube.…”