scholarly journals Cardiopulmonary effects of bronchoalveolar lavage in critically ill patients with ventilator-associated pneumonia

Critical Care ◽  
10.1186/cc817 ◽  
2000 ◽  
Vol 4 (Suppl 1) ◽  
pp. P97
Author(s):  
A Koroneos ◽  
I Kalomenidis ◽  
F Moraitou ◽  
P Polakis ◽  
S Papanikolaou ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Ventilator Associated Pneumonia

scholarly journals Proteomic Profiling of Bronchoalveolar Lavage Fluid in Critically Ill Patients with Ventilator-Associated Pneumonia

PLoS ONE ◽  
2013 ◽  
Vol 8 (3) ◽  
pp. e58782 ◽  
Author(s):  
Elizabeth V. Nguyen ◽  
Sina A. Gharib ◽  
Steven J. Palazzo ◽  
Yu-hua Chow ◽  
David R. Goodlett ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Ventilator Associated Pneumonia ◽  
Proteomic Profiling

scholarly journals Serum Procalcitonin Level and Mortality Risk in Critically ill Patients with Ventilator-Associated Pneumonia

2015 ◽  
Vol 37 (5) ◽  
pp. 1967-1972 ◽  
Author(s):  
Bo Li ◽  
Xin Zhao ◽  
Shumei Li
Keyword(s):  
Critically Ill ◽  
Mortality Risk ◽  
Critically Ill Patients ◽  
Cox Regression ◽  
High Serum ◽  
Ventilator Associated Pneumonia ◽  
Prognostic Role ◽  
Procalcitonin Level ◽  
Increased Risk

Background/Aims: The prognostic role of serum procalcitonin level in critically ill patients with ventilator-associated pneumonia was unclear. The aim of our study was to investigate the relationship between serum procalcitonin level and mortality risk in critically ill patients with ventilator-associated pneumonia. Methods: Data of critically ill patients with ventilator-associated pneumonia were retrospectively collected. Demographics, comorbidities, and serum procalcitonin level were extracted from electronic medical records. The primary outcome was mortality within two months after diagnosis. Multivariable Cox regression analyses were performed to assess the prognostic role of serum procalcitonin level in those patients. Results: A total of 115 critically ill patients with ventilator-associated pneumonia were enrolled in our study. Serum procalcitonin level was not associated with age, gender, or other comorbidities. Univariate Cox regression model showed that high serum procalcitonin level was associated increased risk of morality within 2 months after diagnosis (OR = 2.32, 95% CI 1.25-4.31, P = 0.008). Multivariable Cox regression model showed that high serum procalcitonin level was independently associated increased risk of morality within 2 months after diagnosis (OR = 2.38, 95% CI 1.26-4.50, P = 0.008). Conclusion: High serum procalcitonin level is an independent prognostic biomarker of mortality risk in critically ill patients with ventilator-associated pneumonia, and it's a promising biomarker of prognosis in critically ill patients.

scholarly journals The effects of gastrointestinal function on the incidence of ventilator-associated pneumonia in critically ill patients

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 556-561
Author(s):  
Yuanqiang Lin ◽  
Zhixia Sun ◽  
Hui Wang ◽  
Meihan Liu
Keyword(s):  
Gastric Juice ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Ph Value ◽  
Serum Levels ◽  
Control Group ◽  
Gastrointestinal Function ◽  
Ventilator Associated Pneumonia ◽  
Observation Group ◽  
Gastric Feeding

AbstractObjectiveTo investigate the effect of gastrointestinal function on the incidence of ventilator-associated pneumonia (VAP) in critically ill patients.MethodsFrom August 2012 to June 2016, 160 critically ill patients in the ICU (Intensive Care Unit) of our hospital were selected as the research group; patients were divided equally into an observation group and a control group, 80 patients in each group, based on the random draw envelope principle. The control group was given a nasogastric tube for gastric feeding, the observation group was given a dual lumen gastrointestinal enteral device for gastric feeding; the two groups’ enteral nutrition observation time was 7d; any changes in patient condition and prognosis were recorded.ResultsThe pH value of gastric juice in the control group and the observation group was 6.13±1.38 and 4.01±1.83, respectively: the pH for the observation group was significantly lower than that of the control group (t=4.982, P<0.05). The incidence of VAP in the observation group and the control group was 2.5% and 12.5%, respectively: the VAP for the observation group was significantly lower than that of the control group (P<0.05). The serum levels of pre-albumin and albumin after feeding in the two groups were significantly higher than before feeding (P<0.05); the serum levels of pre-albumin and albumin in the observation group after feeding were significantly higher than those in the control group (P<0.05). The mechanical ventilation time and ICU length of stay in the observation group were 9.12±2.13 days and 12.76±1.98 days, respectively, significantly lower than those of the control group of 10.56±2.89 days and 16.33±2.11 days (P<0.05).ConclusionObstacles to gastrointestinal function in critically ill ICU patients are common; enteral gastric feeding by dual lumen gastrointestinal for can improve the patient’s nutritional status, promote and maintain the normal pH value of gastric juice, thereby reducing the incidence of VAP through rehabilitation of patients.

Effect of Probiotics on Incident Ventilator-Associated Pneumonia in Critically Ill Patients

JAMA ◽  
2021 ◽  
Vol 326 (11) ◽  
pp. 1024
Author(s):  
Jennie Johnstone ◽  
Maureen Meade ◽  
François Lauzier ◽  
John Marshall ◽  
Erick Duan ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Ventilator Associated Pneumonia

Oropharyngeal Bacterial Colonization after Chlorhexidine Mouthwash in Mechanically Ventilated Critically Ill Patients

2018 ◽  
Vol 129 (6) ◽  
pp. 1140-1148 ◽  
Author(s):  
Béatrice La Combe ◽  
Anne-Claire Mahérault ◽  
Jonathan Messika ◽  
Typhaine Billard-Pomares ◽  
Catherine Branger ◽  
...  
Keyword(s):  
Minimal Inhibitory Concentration ◽  
Critically Ill ◽  
Bacterial Growth ◽  
Critically Ill Patients ◽  
Inhibitory Concentration ◽  
Bacterial Colonization ◽  
Contamination Level ◽  
Ventilator Associated Pneumonia ◽  
Minimal Inhibitory Concentrations ◽  
Salivary Concentration

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Oropharyngeal care with chlorhexidine to prevent ventilator-associated pneumonia is currently questioned, and exhaustive microbiologic data assessing its efficacy are lacking. The authors therefore aimed to study the effect of chlorhexidine mouthwash on oropharyngeal bacterial growth, to determine chlorhexidine susceptibility of these bacteria, and to measure chlorhexidine salivary concentration after an oropharyngeal care. Methods This observational, prospective, single-center study enrolled 30 critically ill patients under mechanical ventilation for over 48 h. Oropharyngeal contamination was assessed by swabbing the gingivobuccal sulcus immediately before applying 0.12% chlorhexidine with soaked swabs, and subsequently at 15, 60, 120, 240, and 360 min after. Bacterial growth and identification were performed, and chlorhexidine minimal inhibitory concentration of recovered pathogens was determined. Saliva was collected in 10 patients, at every timepoint, with an additional timepoint after 30 min, to measure chlorhexidine concentration. Results Two hundred fifty bacterial samples were analyzed and identified 48 pathogens including Streptococci (27.1%) and Enterobacteriaceae (20.8%). Oropharyngeal contamination before chlorhexidine mouthwash ranged from 103 to 107 colony-forming units (CFU)/ml in the 30 patients (median contamination level: 2.5·106 CFU/ml), and remained between 8·105 (lowest) and 3·106 CFU/ml (highest count) after chlorhexidine exposure. These bacterial counts did not decrease overtime after chlorhexidine mouthwash (each minute increase in time resulted in a multiplication of bacterial count by a coefficient of 1.001, P = 0.83). Viridans group streptococci isolates had the lowest chlorhexidine minimal inhibitory concentration (4 [4 to 8] mg/l); Enterobacteriaceae isolates had the highest ones (32 [16 to 32] mg/l). Chlorhexidine salivary concentration rapidly decreased, reaching 7.6 [1.8 to 31] mg/l as early as 60 min after mouthwash. Conclusions Chlorhexidine oropharyngeal care does not seem to reduce bacterial oropharyngeal colonization in critically ill ventilated patients. Variable chlorhexidine minimal inhibitory concentrations along with low chlorhexidine salivary concentrations after mouthwash could explain this ineffectiveness, and thus question the use of chlorhexidine for ventilator-associated pneumonia prevention.

Sign in / Sign up

Export Citation Format

Share Document