2002, Number 3
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Med Crit 2002; 16 (3)
Ventilator associated pneumonia
Carrillo ER, Cruz LC, Olais MCA, Vázquez AG, Olivares DE, Calvo CB
Language: Spanish
References: 96
Page: 90-106
PDF size: 116.29 Kb.
ABSTRACT
Ventilator-Associated Pneumonia (VAP) is the most important infection complication occurring in the critically ill patients, increasing intensive care unit length of stay and mortality. In the last years, the scientific information has improved our understanding of the pathogenesis and treatment of VAP. Despite this information misconception continue in the diagnosis and management of those patients.
In the Mexican Consensus of Diagnosis and Management of Pneumonia attended by 25 Mexican researchers, a subgroup constituted by 6 intensivist, made a review of the literature and developed a document related to definition, epidemiology, diagnosis and treatment of VAP. Consensus was focused the importance of prophylaxis and local epidemiology surveillance programs.
REFERENCES
Kollef M. Ventilator associated pneumonia. JAMA 1993;270: 1965-1970.
Celis R, Torres A, Gatell JM et al. Nosocomial pneumonia: a multivariated analysis of risk and prognosis. Chest 1988;93: 318-324.
Torres A, Aznar R, Gatell JM et al. Incidence, risk and prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis 1990;142: 523-528.
Molinar RF, Vázquez HM, Baltazar TJ y cols. Incidencia de neumonía asociada a la ventilación mecánica en pacientes críticos. Rev Asoc Med Crit y Ter Int 2001;15(1): 18-21.
Baker AM, Meredeth JW, Haponik EF. Penumonia in intubated trauma patients: Microbiology and outcomes. Am J Respir Crit Care Med 1996;153:343-349.
Cambell D, Niederman MS, Broughton WA et al. ATS Official statement. Hospital-acquired pneumonia in adults: Diagnosis, assesment of severity, initial antimicrobial therapy, and preventive strategies. A consensus statement. Am J Respir Crit Care Med 1996;153:1771-1725.
Cook D, Guyatt G, Marshall J et al. A comparison of sucralfate and ranitidine for prevention of upper gastrointestinal bleeding in patients requiring mechanical ventilation. Canadian Critical Care Trial Group. N Engl J Med 1998;338: 791-797.
Langer M, Mosconi P, Cigada M et al. Long-term respiratory support and risk of pneumonia in critically ill patients. Am Rev Respir Dis 1989;140:302-305.
Kollef MH, Bock K, Ricard R et al. The safety and diagnostic accuracy of minibronchoalveolar lavage in patients with suspected ventilator-associated pneumonia. Ann Intern Med 1995;122:743-748.
Harlid R, Andersson G, Frostell C. Respiratory tract colonization and infection in patients with chronic tracheostomy. Am J Respir Crit Care Med 1996;154:124-129.
Morar P, Singh V, Jones A et al. Impact of tracheostomy on colonization and infection of lower airway in children requiring long-term ventilation: A prospective observational cohort study. Chest 1998;113:77-85.
Niederman MS, Ferranti RD, Zeigler A et al. Respiratory infection complicating long-term tracheostomy: The implication of persistent gram negative tracheobronchial colonization. Chest 1984;85:39-44.
Niederman MS, Merrill WW, Ferranti RD et al. Nutritional status and bacterial binding in the lower respiratory tract in patients with chronic tracheostomy. Ann Intern Med 1984;100: 795-800.
Fagon JY, Chastre J, Hance A et al. Nosocomial pneumonia in mechanically ventilated patients: A cohort study evaluation attributable mortality and hospital stay. Am J Med 1993;94:281-288.
Fagon JY, Chastre J, Vuagnat A et al. Nosocomial pneumonia and mortality among patients in intensive care units. JAMA 1996;866-869.
Gross PA, Neu HC, Aswapokee P et al. Deaths from nosocomial infection: Experience in a University Hospital and a community hospital. Am J Med 1980;68:219-223.
Johanson WG, Pierce AK, Sanford JP et al. Nosocomial respiratory infections with gram-negative bacilli: the significance of colonization of the respiratory tract. Ann Intern Med 1972;77:701-706.
Johanson WG, Seindenfeld JJ, Gómez P et al. Bacterologic diagnosis of nosocomial pneumonia following prolonged mechanical ventilation. Am Rev Respir Dis 1988;137: 259-264.
Maki DG. Nosocomial bacteremia. An epidemiologic overview. Am J Med 1981;70:719-732.
Meduri GU, Estes RJ. The pathogenesis of ventilator associated pneumonia: II. The lower respiratory tract. Intensive Care Medicine 1992;21:452-461.
Palmer L, Smaldone G, Simon S et al. Tracheal aspirates in long-term mechanically ventilated patients: A human model of gram-negative infection and airway inflammation. Chest 1995;108:1326-1332.
Palmer L, Donelan S, Fox G et al. Gastric lora in chronically mechanically ventilated patients: Relationship to upper and lower airway colonization. Am J Respir Crit Care Med 1995;151:1063-1067.
Papazian L, Bregeon F, Thirion X et al. Effect of ventilator-associated pneumonia on mortality and morbidity. Am J Resp Crit Care Med 1996;154:91-97.
Prod’hom G, Leuenberger P, Koefer J et al. Nosocomial pneumonia in mechanically ventilated patients receiving antiacid, ranitidine or sucralfate as prophylaxis for stress ulcer: A randomized controlled trial. Ann Intern Med 1994;120: 653-662.
Rello J, Díaz E, Roque M et al. Risk factors for developing pneumonia within 48 hours of intubation. Am J Respir Crit Care Med 1999;159:1742-1746.
Rello J, Sonora R, Jubert P et al. Pneumonia in intubated patients: Role of respiratory airway care. Am J Respir Crit Care Med 1996;154:111-115.
Sottile FD, Marrie TJ, Prough DS et al. Nosocomial pulmonary infection: Possible etiologic significance of bacterial adhesion to endotracheal tubes. Crit Care Med 1986;14: 265-270.
Sorensen V, Horst M, Obeid F et al. Endotracheal aminoglycosides in gram-negative pneumonia. Am Surg 1986;52: 391-394.
Torres A, Gatell JM, Aznar E et al. Re-intubation increases the risk for nosocomial pneumonia. Am Surg 1986;52: 391-394.
Niederman MS, Craven DE. Devising strategies for preventing nosocomial pneumonia: Should we ignore the stomach? Clin Infect Dis 1997;24:320-323.
Niederman MS. Pathogenesis of airway colonization: Lessons learned from studies of bacterial adherence. Eur Res J 1994;7:1737-1740.
Cardenosa-Cendrero J, Sole-Violan J, Benitez A et al. Role of different routes of tracheal colonization in the development of pneumonia in patients receiving mechanical ventilation. Chest 1999;116:462-470.
Craven DE, Steger KA. Nosocomial pneumonia in mechanically ventilated adult patients: Epidemiology and prevention in 1996. Semin Respir Infect 1996;11:32-53.
Fagon JY, Chastre J, Hance AJ et al. Detection of nosocomial lung infection in ventilated patients. Am Rev Respir Dis 1989;136:877-884.
American Thoracic Society. Hospital-acquired pneumonia in adults: Diagnosis, assessment of severity, initial antimicrobial therapy, and preventive strategies; a consensus statement. Am J Respir Crit Care Med 1995;153:1711-1725.
Alvarez-Lerma. Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit: The ICU-Acquired pneumonia study Group. Intensive Care Med 1996;22:387-394.
Garrard CHS, A’Court CD. The diagnosis of pneumonia in the critically ill. Chest 1995;108(suppl):17-25.
Meduri GU, Mauldin GL, Wunderink RG et al. Causes of fever and pulmonary densities in the patients with clinical manifestations of ventilator-associated pneumonia. Chest 1994;106:221-235.
Pugin J, Aucgenthaler R, Mili N et al. Diagnosis of ventilator associated pneumonia by bacteriologic analysis of bronchoscopic and no bronchoscopic “blind” Bronchoalveolar lavage fluid. Am Rev Respir Dis 1991;143:1121-1129.
Andrews CP, Coalson JJ, Smith JD et al. Diagnosis of nosocomial bacterial pneumonia in the acute diffuse lung injury. Chest 1981;80:254-258.
Wunderink RG, Woldenberg L, Zeiss J et al. Radiologic-diagnosis of autopsy-proven ventilator-associated pneumonia. Chest 1992;101:458-463.
Wunderink RG. Clinical criteria in the diagnosis of ventilator-associated pneumonia. Chest 2000;117:191s-194s.
Torres A, Aznar R, Gatell JM et al. Incidence, risk, and the prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis 1990;142:523-528.
Torres A, Al-Ebiary M. Brochoscopic BAL in the diagnosis of ventilator associated pneumonia. Chest 2000;117:198-202.
Torres A, Martos A, Puig de la Bellacasa J et al. Specificity of endotracheal aspiration, protected specimen brush, and brochoalveolar lavage in mechanically ventilated patients with suspected pneumonia. Am Rev Respir Dis 1993;147: 952-957.
Ricards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit Care Med 1999;20:653-670.
Wunderink RG. Clinical criteria in the diagnosis of ventilator associated pneumonia. Chest 2000;117:191s-194s.
Rello J, Gallego M, Mariscal R, Sonora R, Valles J. The impact of routine microbial investigation in ventilator-associated pneumonia. Am J Respir Crit Care Med 1997;156:196-100.
Fagon JY, Chastre J, Wolff M et al. Invasive and no invasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial. Ann Intern Med 2000;136:621-630.
Inglis TJ, Millar MR, Jones GR et al. Tracheal tube biofilm as a source of bacterial colonization of the lung. J Clin Microbiol 1989;27:2014-2018.
Jorda R, Parras F, Ibañez J et al. Diagnosis of nosocomial pneumonia in mechanically ventilated patients by the blind protected telescoping cateter. Intensive Care Med 1993;19: 377-382.
Cook D, Mandell L. Endotracheal aspiration in the diagnosis of ventilator-associated pneumonia. Chest 2000;117: 195-197.
Gerbeaux P, Ledoray V, Boussuges A et al. Diagnosis of nosocomial pneumonia in mechanically ventilated patients: Repeatability of broncheoalveolar lavage. Am J Respir Crit Care Med 1998;157:76-80.
Chastre J, Fagon JY, Bornet-Lesco M et al. Evaluation of bronchoscopic techniques for the diagnosis of nosocomial pneumonia. Am J Respir Crit Care Med 1995;152:231-240.
Chastre J, Viau F, Brun P et al. Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated patients. Am Rev Respir Dis 1984;130:924-929.
Dreyfuss D, Mier L, Le Bourdelles G et al. Clinical significance of borderline quantitative protected brush specimen culture results. Am Rev Respir Dis 1999;148:1552-1557.
Hayland DK, Cook D, Marschall J et al. For the canadian critical care trials group: the clinical utility of invasive diagnostic techniques in the setting of ventilator associated pneumonia. Chest 1999;115:1076-1084.
De Jaeger A, Litalien C, Lacroix J et al. Protected specimen brush (PSB) or bronchoalveolar lavage to diagnose bacterial nosocomial pneumonia in ventilated adults: A metanalysis. Crit Care Med 1999;27:2548-2560.
Kollef M, Bock KR, Ricards RD et al. The safety and diagnostic accuracy of minibronchoalveolar lavage in patients with suspected ventilator-associated pneumonia. Ann Intern Med 1995;122:743-748.
Kollef MH, Elsenberg PR, Ohlndorf MF et al. The accuracy, of elevated concentrations of endotoxin in bronchoalveolar lavage fluid for the rapid diagnosis of gram positive pneumonia. Am J Respir Crit Care Med 1996;154:1020-1028.
Luna C, Vujachich P, Niederman NS et al. Impact of BAL data on the therapy and outcome of ventilator associated pneumonia. Chest 1997;111:676-687.
Marquette CH, Georges H, Wallet F et al. Diagnosis efficiency of endotracheal aspirates with quantitative bacterial cultures in intubated patients with suspected pneumonia. Am Rev Respir Dis 1993;148:138-144.
Meduri GU, Beals D, Maijub AG et al. Protected bronchoalveolar lavage. A new bronchoscopic technique to retrieve uncontaminated distal airway secretions. Am Rev Respir Dis 1991;143:855-864.
Niederman MS. Bronchoscopy for ventilator associated pneumonia: Show me the money (outcome benefit). Crit Care Med 1998;26:198-199.
Niederman MS, Torres A, Summer W. Invasive diagnostic testing is not needed routinely to manage suspected ventilator associated pneumonia. Am J Resp Crit Care Med 1994;150:565-569.
Ruiz M, Torres A, Ewing S et al. Noninvasive versus invasive microbial investigation in ventilator associated pneumonia: Evaluation of outcome. Am J Resp Crit Care Med 2000;162: 119-125.
Rouby JJ, Martin De Lassal E et al. Nosocomial bronchopneumonia in the critically ill. Histologic and bacteriologic aspects. Am Rev Respir Dis 1992;146:1059-1066.
Wermet D, Marquette CH, Copin MC et al. Influence of pulmonary bacteriology and histology on the yield of diagnostic procedures in ventilator acquired pneumonia. Am J Respir Crit Care Med 1998;158:139-147.
Corley DE, Kirtland SH, Winterbauer R et al. Reproducibiilty of the histologic diagnosis of pneumonia among a panel of four pathologist. Analysis of a gold standard. Chest 1997;112:458-465.
Fabregas N, Ewing S, Torres A et al. Clinical diagnosis of ventilator associated pneumonia revisited: Comparative evaluation using immediate postmortem biopsies. Thorax 1999;54:867-873.
Fabregas N, Torres A, El-Ebiary M et al. Histopathologic and microbiologic aspects of ventilator associated pneumonia. Anesthesiology 1996;84:760-771.
Marquette CH, Copin MC, Wallet F et al. Diagnostic tests for pneumonia in ventilated patients: Prospective evaluation of diagnostic accuracy using histology as a diagnostic gold standard. Am J Resp C rit Care Med 1995;151:1878-1888.
Marquette CH, Wallet F, Copin MC et al. Relationship between microbiologic and histologic features in bacterial pneumonia. Am J Respir Crit Care Med 1996;154:1784-1787.
Rello J, Paiva AJ, Baraqibar J et al. International Conference for the Development of Consensus on the Diagnosis and Treatment of Ventilator Associated Pneumonia. Chest 2001;120:
Ibrahim EH, Ward S, Sherman G et al. A comparative analysis of patients with early onset vs late onset nosocomial pneumonia in the ICU setting. Chest 2000;117: 1442-1734.
Craven DE. Epidemiology of ventilator associated pneumonia. Chest 2000;117:186-187.
Vincent JL, Bihari JD, Suter PM et al. The prevalence of nosocomial infections in intensive care units in Europe: resuls of the European prevalence of infections in Intensive Care (EPIC) Study. JAMA 1995;274:639-644.
Baker AM, Meredith JW, Apnik EF. Pneumonia in intubated trauma patients: Microbiology and outcomes. Am J Respir Crit Care Med 1996;153:343-349.
Rello J, Sá-Borges M, Correa H et al. Variations in etiology of ventilator-associated pneumonia around four treatment site: Implications for antimicrobial prescribing practices. Am J Respir Crit Care Med 1999;160:608-613.
Villers D, Espaze E, Coste-Burel M et al. Nosocomial Acinetobacter baumannii infections: Microbiological and clinical epidemiology. Ann Intern Med 1998;129:182-189.
Robert R, Grollier G, Dore P et al. Nosocomial pneumonia with isolation of anaerobic bacteria in ICU patients: Therapeutic considerations and outcome. J Crit Care 1999;14: 114-119.
Chastre J, Trouillet J, Vaugnat A et al. Nosocomial pneumonia in patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med 1998;157:1165-1172.
Seidenfeld JJ, Pohl DF, Bell RD et al. Incidence, site, and outcome of infections in patients with acute respiratory distress syndrome. Am Rev Respir Dis 1986;134:12-16.
American Thoracic Society. Hospital acquired pneumonia in ventilated patients: diagnosis, assesment of severity, initial antimicrobial therapy and preventative. Am J Respir Crit Care Med 1995;153:1711-1725.
Trouillet JL, Chastre J, Vaugnat A et al. Ventilator associated pneumonia caused by potentially drug resistant bacteria. Am J Respir Crit Care Med 1998;157: 531-539.
Carter AB, Hornick DB. Therapy for ventilator associated pneumonia. Clin Chest Med 1999;20:681-691.
Niederman MS, Mantovani R, Schoch P et al. Pneumonia in the critically ill hospitalized patient. Chest 1990;97:170-181.
Rello J, Mariscal D, March F et al. Recurrent Pseudomonas aeruginosa pneumonia in ventilated patients: Relapse or reinfection? Am J Respir Crit Care 1998;157:912-916.
Cisneros J, Reyes M, Pachon J et al. Bacteremia caused by Acinetobacter baumannii: epidemiology, clinical findings and prognostic features. Clin Infect Dis 1996;22:1026-1032.
Rello J. Acinetobacter baumannii infection in the ICU: customization is the key. Chest 1999; 115:1226-1229.
Fagon J, Lavarde V, Novara A. Nosocomial Candida infections of the lower respiratory tract in ICU patients. Am J Respir Crit Care 1994;150: A650.
Pujol M, Corbella X, Peña C et al. Clinical and epidemiological findings in mechanically ventilated patients with methicillin-resistant Staphylococcus aureus pneumonia. Eur J Clin Microbiol Infect Dis 1998;17:622-628.
Rello J, Quintana E, Ausina V et al. Risk factors for Staphylococcus aureus nosocomial pneumonia in critically ill patients. Am Rev Respir Dis 1990;142:1320-1324.
Kollef MH. The prevention of ventilator associated pneumonia. N Engl J Med 1999;340:627-634.
Kollef MH, Viasnik J, Shrapless L et al. Scheduled change of antibiotic classes: A strategic to decrease the incidence of ventilator associated pneumonia. Am Rev Respir Crit Care Med 1997;156:1040-1048.
Tablan OC, Anderson LJ, Arden NH et al. Guideline for prevention of nosocomial pneumonia: Part I. Issues on prevention of nosocomial pneumonia, 1994. Infec Control Hosp Epidemiol 1994;15:588-625.