Original scientific paper

https://doi.org/10.20471/acc.2016.55.01.15

The Impact of Tracheotomy on the Clinical Course of Ventilator-Associated Pneumonia

Tihana Magdić Turković orcid.org/0000-0003-1193-512X ; Department of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Center, Zagreb; Croatia
Anita Lukić ; Department of Anesthesiology, Resuscitation and Intensive Care, Varaždin General Hospital, Varaždin, Croatia
Iva Pažur ; Department of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Center, Zagreb; Croatia
Ognjen Ožegić ; Department of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Center, Zagreb; Croatia
Melanija Obraz ; Department of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Center, Zagreb; Croatia

Abstract

Ventilator-associated pneumonia (VAP) is the most common infection among intensive care unit (ICU) patients. The aim of the present study was to evaluate the impact of tracheotomy on VAP clinical course. The study was conducted in a 15-bed Surgical and Neurosurgical ICU, Department of Anesthesiology and Intensive Care, Sestre milosrdnice University Hospital Center in Zagreb, Croatia. All patients developing VAP during ICU stay were eligible for the study.
In VAP patients not tracheotomized during ICU stay, the mortality rate was approximately two times higher as compared with patients tracheotomized either before or after VAP onset (crude risk ratio 1.83, 95% confidence interval (95% CI) 1.15-2.91, p=0.01; crude odds ratio 3.47, 95% CI 1.52-7.94; p=0.003). In the surviving VAP patients, the duration of mechanical ventilation before VAP onset was higher in the “T before VAP” group as compared with the “no T before VAP” group (8, 6-10 vs. 3, 2-5; p<0.001), but the number of post-VAP days on mechanical ventilation was shorter in “T before VAP” patients than in “no T before VAP” patients (0, 0-1 vs. 4, 3-9; p<0.001). The duration of mechanical ventilation after VAP onset in the “T after VAP” group was longer as compared with the “T before VAP” group (4, 3-12 vs. 0, 0-1; p<0.001). The present study indicated tracheotomy to be associated with a reduced duration of mechanical ventilation after VAP onset, but only if patients were tracheotomized at the moment of VAP onset.

Keywords

Critical care; Tracheotomy; Pneumonia, ventilator-associated; Prognosis; Survival analysis; Treatment outcome

Hrčak ID:

161284

URI

https://hrcak.srce.hr/161284

Publication date:

1.3.2016.

Article data in other languages: croatian

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