Pneumonia associated with mechanical ventilation (VAP): influence on morbidity and mortality in critically ill patients

Introduction

VAP is an avoidable complicating factor and may change the morbidity and mortality of critical patients under mechanical ventilation.

Aim

To evaluate the effects of VAP on morbidity and mortality in critically ill patients.

Methods

In this retrospective study, 141 ICU patients were evaluated from January 1997 to November 1999. All patients were submitted to artificial ventilation for more than 48 h and did not present signs, symptoms or laboratory tests that could suggest pneumonia at the start of mechanical ventilation. Patients were divided in two groups: group 1 (with VAP) and group 2 (without VAP). The following variables were correlated with VAP: age, APACHE II and time under mechanical ventilation. Statistical analysis included Student's t-test, Mann-Whitney and Χ² test (P < 0.05).

Results

No difference was found for age (P = 0.08), mortality (P = 0.25) and for APACHEII values (P = 0.09) between patients from groups 1 and 2. Patients with VAP showed longer ventilation times (P = 0.0001) than patients without VAP (Table).

Table

Conclusion

All preventive methods should be employed to avoid VAP in critically ill patients since the evaluated group in this study remained under mechanical ventilation for a significantly longer period than patients without VAP, although the mortality rate was unaffected.