title: Zinc Supplementation in Adult Mechanically Ventilated Trauma Patients is Associated with Decreased Occurrence of Ventilator-associated Pneumonia: A Secondary Analysis of a Prospective, Observational Study.
abstract: BACKGROUND
  Ventilator-associated pneumonia (VAP) is a type of lung infection that typically affects critically ill patients undergoing mechanical ventilation (MV) in the Intensive Care Unit (ICU). The aim of this analysis is to determine potential association between zinc supplementation with the occurrence of VAP in adult mechanically ventilated trauma patients.
  
  
  METHODS
  This secondary analysis of a prospective observational study was carried out over a period of 1 year in ICUs of one teaching hospital in Iran. A total of 186 adults mechanically ventilated trauma patients, who required at least 48 h of MV and received zinc sulfate supplement (n= 82) or not (n= 104) during their ICU stay, were monitored for the occurrence of VAP until their discharge from the ICU or death.
  
  
  RESULTS
  Forty-one of 186 patients developed VAP, 29.09 days after admission (95% confidence interval [CI]: 26.27-31.9). The overall incidence of VAP was 18.82 cases per 1000 days of intubation (95% CI: 13.86-25.57). Patients who received zinc sulfate supplement have smaller hazard of progression to VAP than others (hazard ratio: 0.318 [95% CI: 0.138-0.732];P< 0.0001).
  
  
  CONCLUSIONS
  The findings show that zinc supplementation may be associated with a significant reduction in the occurrence of VAP in adult mechanically ventilated trauma patients. Further well-designed randomized clinical trials to confirm the efficacy of this potential preventive modality are warranted.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Farshad
authors.initials: F
authors.lastname: Hasanzadeh Kiabi
authors.affiliation: Department of Community Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Alipour
authors.affiliation: Department of Nursing, Sari Branch, Islamic Azad University, Sari, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Darvishi-Khezri
authors.affiliation: Student Research Committee, Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Aily
authors.initials: A
authors.lastname: Aliasgharian
authors.affiliation: Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Emami Zeydi
keywords: Intensive Care Units; supplementation; ventilator-associated pneumonia; zinc sulfate