Incidence and Impact of Ventilator-Associated Pneumonia in ICU Patients with Severe Pneumonia and Respiratory Failure: A Prospective Study
Abstract
Ventilator-associated pneumonia (VAP) is a critical complication affecting intensive care unit (ICU) patients with severe pneumonia and respiratory failure, significantly impacting morbidity and mortality rates. This prospective study aims to investigate the incidence, clinical outcomes, and risk factors associated with VAP in this vulnerable patient population. Data were collected from ICU admissions at Tertiary Care Hospital in Central India between June 2023 and December 2023, focusing on patients diagnosed with severe pneumonia and requiring mechanical ventilation. The incidence of VAP, defined by clinical criteria and microbiological confirmation, was assessed alongside patient outcomes, including length of ICU stay, mortality rates, and antibiotic utilization. Multivariate analysis identified independent predictors of VAP occurrence and associated complications. Findings underscore the profound clinical implications of VAP in ICU settings, emphasizing the need for rigorous preventive strategies and optimized management protocols to improve patient outcomes.
Introduction: Ventilator-associated pneumonia (VAP) is a prevalent nosocomial infection among critically ill patients requiring mechanical ventilation in intensive care units (ICUs). It complicates the management of severe pneumonia and respiratory failure, posing substantial challenges due to its association with increased morbidity, mortality, and healthcare costs. The incidence of VAP varies widely, influenced by patient-specific factors, ICU practices, and antimicrobial resistance patterns. Early recognition and appropriate management are crucial to mitigate the impact of VAP on patient outcomes. This prospective study aims to explore the incidence, clinical impact, and risk factors associated with VAP specifically in ICU patients with severe pneumonia and respiratory failure at Chirayu Medical College & Hospital.
Methods: This prospective cohort study included ICU patients diagnosed with severe pneumonia and requiring mechanical ventilation, admitted to a Tertiary Care Hospital in Central India between June 2023 and December 2023. Data were collected prospectively from electronic health records, focusing on demographic characteristics, comorbidities, severity of illness scores, and microbiological profiles. VAP was diagnosed based on clinical criteria including new or progressive infiltrates on chest radiography, purulent respiratory secretions, fever, leukocytosis, and microbiological confirmation from lower respiratory tract specimens. Clinical outcomes such as ICU length of stay, duration of mechanical ventilation, mortality rates, and antibiotic utilization were analyzed. Multivariate logistic regression was performed to identify independent predictors of VAP occurrence and associated complications.
Results: Our study enrolled a total of 100 ICU patients, with 30 patients diagnosed with ventilator-associated pneumonia (VAP) and 70 patients without VAP (Non-VAP).
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