Author, as appears in the article.: Zampieri, Fernando G.; Povoa, Pedro; Salluh, Jorge, I; Rodriguez, Alejandro; Valade, Sandrine; Gomes, Jose Andrade; Reignier, Jean; Molinos, Elena; Almirall, Jordi; Boussekey, Nicolas; Socias, Lorenzo; Ramirez, Paula; Viana, William N.; Rouze, Anahita; Nseir, Saad; Martin-Loeches, Ignacio;TAVeM Study Grp

Department: Medicina i Cirurgia

URV's Author/s: Rodríguez Oviedo, Alejandro Hugo

Keywords: Ventilator-associated pneumonia Prognosis Multicenter Critical care Attributable mortality Ards Acute respiratory distress syndrome

Abstract: Objective: To assess whether ventilator-associated lower respiratory tract infections (VA-LRTIs) are associated with mortality in critically ill patients with acute respiratory distress syndrome (ARDS). Materials and Methods: Post hoc analysis of prospective cohort study including mechanically ventilated patients from a multicenter prospective observational study (TAVeM study); VA-LRTI was defined as either ventilator-associated tracheobronchitis (VAT) or ventilator-associated pneumonia (VAP) based on clinical criteria and microbiological confirmation. Association between intensive care unit (ICU) mortality in patients having ARDS with and without VA-LRTI was assessed through logistic regression controlling for relevant confounders. Association between VA-LRTI and duration of mechanical ventilation and ICU stay was assessed through competing risk analysis. Contribution of VA-LRTI to a mortality model over time was assessed through sequential random forest models. Results: The cohort included 2960 patients of which 524 fulfilled criteria for ARDS; 21% had VA-LRTI (VAT = 10.3% and VAP = 10.7%). After controlling for illness severity and baseline health status, we could not find an association between VA-LRTI and ICU mortality (odds ratio: 1.07; 95% confidence interval: 0.62-1.83; P = .796); VA-LRTI was also not associated with prolonged ICU length of stay or duration of mechanical ventilation. The relative contribution of VA-LRTI to the random forest mortality model remained constant during time. The attributable VA-LRTI mortality for ARDS was higher than the attributable mortality for VA-LRTI alone. Conclusion: After controlling for relevant confounders, we could not find an association between occurrence of VA-LRTI and ICU mortality in patients with ARDS.

Thematic Areas: Medicina ii Medicina i General medicine Emergency medicine & critical care Educação física Critical care medicine Critical care and intensive care medicine

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: alejandrohugo.rodriguez@urv.cat

Author identifier: 0000-0001-8828-5984

Record's date: 2023-09-02

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://journals.sagepub.com/doi/10.1177/0885066618772498

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Journal Of Intensive Care Medicine. 35 (6): 588-594

APA: Zampieri, Fernando G.; Povoa, Pedro; Salluh, Jorge, I; Rodriguez, Alejandro; Valade, Sandrine; Gomes, Jose Andrade; Reignier, Jean; Molinos, Elena; Al (2020). Lower Respiratory Tract Infection and Short-Term Outcome in Patients With Acute Respiratory Distress Syndrome. Journal Of Intensive Care Medicine, 35(6), 588-594. DOI: 10.1177/0885066618772498

Article's DOI: 10.1177/0885066618772498

Entity: Universitat Rovira i Virgili

Journal publication year: 2020

Publication Type: Journal Publications