Risk factors for developing pneumonia within 48 hours of intubation.
Two hundred fifty intubated patients were followed during the first 48 h after intubation in order to identify potential risk factors for developing pneumonia within this period. Thirty-two developed pneumonia during this time. Univariate analysis established that large volume aspiration, presence of sedation, intubation caused by respiratory/cardiac arrest or decrease in the level of consciousness, emergency procedure, cardiopulmonary resuscitation (CPR), and Glasgow coma score < 9 were significantly associated with pneumonia. In contrast, prior infection and prior antimicrobial use were associated with a protective effect. Presence of subglottic secretion drainage and 15 other variables had no significant effect. Multivariate analysis selected CPR (odds ratio [OR] = 5.13, 95% confidence intervals [CI] = 2.14, 12.26) and continuous sedation (OR = 4.40, 95% CI = 1.83, 10.59) as significant risk factors for pneumonia, while antibiotic use (OR = 0.29, 95% CI = 0.12, 0.69) showed a protective effect. Our findings emphasize that risk factors for pneumonia change during the intubation period, and preventing pneumonia requires a combined approach.
Rello
J
J
Pulmonary and Critical Care Departments, Hospital de Sabadell, and CEPSS/FPT, Sabadell, Barcelona, Spain. JRELLO@CSPT.es
Diaz
E
E
Roque
M
M
Vallés
J
J
D001424:Bacterial Infections; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects; D015331:Cohort Studies; D003243:Consciousness / Q000502:physiology; D004632:Emergency Medical Services; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D015994:Incidence; D007440:Intubation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
D006993:Hypnotics and Sedatives