title: Ventilation-associated pneumonia after intubation in the prehospital or the emergency unit.
abstract: The aim of the study was to evaluate the prevalence and the risk factors of ventilation-associated pneumonia (VAP) for out-of-hospital or in the emergency department intubated patients. This was a retrospective descriptive study. All intubated adults subsequently admitted to the ICU over 1-year period were included. Among 75 patients, 15 patients developed VAP (20%; 95% CI 12-31%). A multivariate analysis revealed three variables independently associated with VAP: cardiorespiratory arrest as the reason of intubation (P=0.001), out-of-hospital as the location of intubation (P=0.011), and clinical macroaspiration as clinical characteristic at the time of intubation (P=0.024). Death rate was 17% and was not significantly higher for patients with VAP (P=0.9; 95% CI 0.32-4.95%). Emergency care workers should be aware of the potential 20% occurrence of VAP when they intubate and ventilate a patient. Preventive strategies, which have been proven effective in ICUs, should be implemented in the emergency setting.
authors.affiliation: Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Lydie
authors.initials: L
authors.lastname: Decelle
authors.forename: Frédéric
authors.initials: F
authors.lastname: Thys
authors.forename: Francis
authors.initials: F
authors.lastname: Zech
authors.forename: Franck
authors.initials: F
authors.lastname: Verschuren
mesh_terms: D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005260:Female; D006323:Heart Arrest; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D053120:Respiratory Aspiration / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors