Predictive factors for septic shock in patients with ventilator-associated pneumonia

Abstract

Background: Ventilator-associated pneumonia (VAP) is one of the most frequent infections in intensive care units (ICUs), and nearly 50% of patients with VAP develop septic shock. Septic shock is an independent predictor for mortality in these patients.

Objective: To investigate the predictors for septic shock in VAP patients receiving appropriate antibiotic therapy.

Methods: Eighty-nine patients with microbiologically confirmed VAP who were receiving appropriate antibiotic therapy were included in the study. They were divided into two groups according to the existence of septic shock. Clinical, hematological, biochemical and microbiological characteristics were compared.

Results: Thirty-seven percent of the patients developed septic shock. Advanced age (OR 1.07, 95% CI 1.02-1.13, P = 0.009), lymphocytopenia (<1000/mm3) (OR 7.48, 95% CI 1.91-29, P = 0.004), high blood glucose levels >120 mg/dL (OR 4.75, 95% CI 1.38-16, P = 0.014), and increased clinical pulmonary infection scores (CPIS) (OR 1.64, 95% CI 1.16-2.33, P = 0.006) were identified as independent predictors for the development of septic shock.

Conclusion: Some clinical parameters such as lymphocytopenia, blood glucose >120 mg/dL, increasing age, and CPIS can predict septic shock during VAP, but large randomized controlled studies are needed to confirm these results.