Is prehospital endobronchial intubation a risk factor for subsequent ventilator associated pneumonia? A retrospective analysis

• DOI: 10.1371/journal.pone.0217466
• Publication Date: 2019-05-23T18:47:24Z
• Authors: Ana Catalina Hern...; Timothée Trampont; Thomas Lafon; Thomas Daix; Dominique Cailloce; Olivier Barraud; François Dalmay; Philippe Vignon; Bruno François
• Keywords: Ventilator-associated Pneumonia

More than half of patients under mechanical ventilation in the intensive care unit (ICU) are field-intubated, which is a known risk factor for ventilator associated pneumonia (VAP). We assessed whether field endobronchial intubation (EBI) with development subsequent VAP during ICU stay. This retrospective, nested case-control study was conducted cohort field-intubated admitted to an teaching hospital three-year period. Cases were defined as EBI and controls corresponded proper position tracheal tube on admission chest X-ray. Primary endpoint early VAP. Secondary endpoints included tracheo-bronchitis, late VAP, duration ventilation, length stay mortality ICU. A total 145 studied (mean age: 54 ± 19 years; men: 74%). Reasons predominantly multiple trauma (49%) cardiorespiratory arrest (38%). identified 33 (23%). Fifty-three (37%) developed or after nearly two-fold increase though not statistically significant (30% vs. 17%: p = 0.09). No difference found regarding secondary outcomes. The present suggests that inadvertent prehospital could be higher incidence early-onset Larger studies required confirm this hypothesis. Whether strategies aimed at decreasing reduce remains determined.