Ventilator-associated pneumonia in critically ill patients with subarachnoid haemorrhage: single-centre experience

Michał Pluta; Mateusz N. Zachura; Sebastian Maślanka; Karolina Sztuba; Jolanta Mika; Katarzyna Marczyk; Łukasz Krzych

doi:10.5114/ms.2023.134084

eISSN: 2300-6722
ISSN: 1899-1874

Medical Studies/Studia Medyczne

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4/2023
vol. 39

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abstract:

Original paper

Ventilator-associated pneumonia in critically ill patients with subarachnoid haemorrhage: single-centre experience

Michał P. Pluta

^{1, 2}

,

Mateusz N. Zachura

¹

,

Sebastian Maślanka

³

,

Karolina Sztuba

³

,

Jolanta Mika

³

,

Katarzyna Marczyk

³

,

Łukasz J. Krzych

^{1, 2}

Department of Acute Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
Department of Cardiac Anaesthesia and Intensive Therapy, Silesian Centre for Hearth Diseases, Zabrze, Poland
Students’ Scientific Society, Department of Acute Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia

Medical Studies/Studia Medyczne 2023; 39 (4): 334-341

DOI: https://doi.org/10.5114/ms.2023.134084

Online publish date: 2023/12/30

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Introduction
The need for prolonged mechanical ventilation (MV) in patients with subarachnoid haemorrhage (SAH) increases the risk of developing ventilation-associated pneumonia (VAP).

Aim of the research
To assess the prevalence of VAP and to determine its aetiological factors.

Material and methods
The study group consisted of 58 critically ill patients treated between 01.2019 and 10.2021. Demographic and clinical data were collected, including the method of collecting material from the respiratory tract, and results of laboratory and microbiological tests.

Results
More than 97% of patients were intubated on the day of admission to the ICU. The median duration of MV was 8 days (IQR: 3–19). On admission, 47 microbiological samples from the respiratory tract (39 endotracheal aspirates, 8 bronchopulmonary lavage) were collected, 26 of which (55%) were physiological flora. In the following days, VAP was diagnosed in 9/47 patients (19%). The median time from admission to diagnosis was 3.5 days (IQR: 3–4.5). Multi-drug-resistant species were found in 3 patients (K. pneumoniae ESBL+). In-hospital mortality among patients with VAP was 62%. None of the patients with SAH and VAP was liberated from ventilator.

Conclusions
In patients with SAH, early-onset VAP is frequent, and its aetiology is unrelated with bacterial colonization found on ICU admission. Even in EO-VAP, multidrug-resistant (MDR) bacteria must be suspected, mostly causing hospital-acquired pneumonia. Prognosis of patients with SAH who develop VAP is poor.

keywords:

Ventilator-associated pneumonia in critically ill patients with subarachnoid haemorrhage: single-centre experience

Michał P. Pluta 1, 2 , Mateusz N. Zachura 1 , Sebastian Maślanka 3 , Karolina Sztuba 3 , Jolanta Mika 3 , Katarzyna Marczyk 3 , Łukasz J. Krzych 1, 2

embolisation, intracranial aneurysm, subarachnoid haemorrhage, ventilator-associated pneumonia

Michał P. Pluta

^{1, 2}

,

Mateusz N. Zachura

¹

,

Sebastian Maślanka

³

,

Karolina Sztuba

³

,

Jolanta Mika

³

,

Katarzyna Marczyk

³

,

Łukasz J. Krzych

^{1, 2}