Ventilator-associated pneumonia in patients with cerebral depression.
BACKGROUND
Bacterial nosocomial ventilator-associated pneumonias are common complications in critically-ill patients. The aim of the present study was to determine the significance of the quantitative changes of consciousness of various etiology as a risk factor for the development of this type of pneumonia.


METHODS
The present prospective study included 81 patients with depressed level of consciousness of different etiology who had developed bacterial nosocomial pneumonia.


RESULTS
Nosocomial pneumonia was diagnosed in 17 (20.98%) patients on mechanical ventilation. No evidence of pulmonary infection was found in the remaining 64 (79.02%) patients. In 2 (2.46%) cases which received thiopental we detected nosocomial pulmonary infection. Forty-six patients (56.79%) underwent neurosurgical interventions. Pneumonia was found in 11 cases (13.58%).


CONCLUSIONS
Suppression of brain activity and the ensuing depressed levels of consciousness as reasons for admission to an intensive-care unit cause a statistically significant increase of the risk of bacterial nosocomial pneumonia developing in patients on mechanical ventilation. Thiopental therapy did not affect the frequency of pulmonary infections. The neurosurgeries we conducted did not increase significantly the risk for nosocomial infections.
Dimov
Gospodin S
GS
Department of Anesthesiology, Emergency and Intensive-care medicine, University Hospital, Trakia University, Stara Zagora, Bulgaria. gdimov@abv.bg
Karakolev
Zhivko T
ZT
Kalchev
Ivan Y
IY
Dobrev
Kiril D
KD
D003244:Consciousness Disorders / Q000150:complications* / Q000473:pathology / Q000628:therapy; D003422:Critical Care; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007362:Intensive Care Units; D019635:Neurosurgical Procedures / Q000009:adverse effects; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000209:etiology*; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects*; D012307:Risk Factors; D013874:Thiopental / Q000008:administration & dosage
D006993:Hypnotics and Sedatives; D013874:Thiopental