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. 2020 Oct 29;9(11):3508.
doi: 10.3390/jcm9113508.

Characteristics and Outcomes in Patients with Ventilator-Associated Pneumonia Who Do or Do Not Develop Acute Respiratory Distress Syndrome. An Observational Study

Enric Barbeta  1   2   3 , Adrian Ceccato  2   3 , Antoni Artigas  4 , Miquel Ferrer  1   2 , Laia Fernández  1   2 , Rubén López  1   2 , Leticia Bueno  1   2 , Anna Motos  1   2 , Gianluigi Li Bassi  5 , Ricard Mellado  6 , Carlos Ferrando  6 , Andrea Catalina Palomeque  1 , Mauro Panigada  7 , Albert Gabarrús  1   2 , Diego de Mendoza  3 , Antoni Torres  1   2
Affiliations

Characteristics and Outcomes in Patients with Ventilator-Associated Pneumonia Who Do or Do Not Develop Acute Respiratory Distress Syndrome. An Observational Study

Enric Barbeta et al. J Clin Med. .

Abstract

Ventilator-associated pneumonia (VAP) is a well-known complication of patients on invasive mechanical ventilation. The main cause of acute respiratory distress syndrome (ARDS) is pneumonia. ARDS can occur in patients with community-acquired or nosocomial pneumonia. Data regarding ARDS incidence, related pathogens, and specific outcomes in patients with VAP is limited. This is a cohort study in which patients with VAP were evaluated in an 800-bed tertiary teaching hospital between 2004 and 2016. Clinical outcomes, microbiological and epidemiological data were assessed among those who developed ARDS and those who did not. Forty-one (13.6%) out of 301 VAP patients developed ARDS. Patients who developed ARDS were younger and presented with higher prevalence of chronic liver disease. Pseudomonas aeruginosa was the most frequently isolated pathogen, but without any difference between groups. Appropriate empirical antibiotic treatment was prescribed to ARDS patients as frequently as to those without ARDS. Ninety-day mortality did not significantly vary among patients with or without ARDS. Additionally, patients with ARDS did not have significantly higher intensive care unit (ICU) and 28-day mortality, ICU, and hospital length of stay, ventilation-free days, and duration of mechanical ventilation. In summary, ARDS deriving from VAP occurs in 13.6% of patients. Although significant differences in clinical outcomes were not observed between both groups, further studies with a higher number of patients are needed due to the possibility of the study being underpowered.

Keywords: acute respiratory distress syndrome; epidemiology; ventilator-associated pneumonia.

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Conflict of interest statement

The authors declare to not have any conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study population. Abbreviations: ARDS, acute respiratory distress syndrome; HAP, hospital-acquired pneumonia; ICU-AP, intensive care unit-acquired pneumonia; VAP, ventilator-associated pneumonia.
Figure 2
Figure 2
Kaplan–Meier survival curves at 90 days.
See this image and copyright information in PMC

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