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The aim is to describe the incidence, characteristics, risk factors and outcome of complications acquired under mechanical ventilation (called ventilator-associated events) according to the new CDC criteria, in a population of patients admitted in intensive care unit after cardiac arrest.
Cardiac arrest (CA) survivors are frequently admitted to intensive care units. Despite improvements in management techniques, the prognosis of these patients remains poor, with mortality exceeding 90% for out-of-hospital CA and around 80% for in-hospital CA, along with a high risk of severe neurological issue.
The management of these patients in intensive care requires the use of invasive mechanical ventilation. Complications occurring under mechanical ventilation have been the subject of many researches. Early bacterial pneumonia or ventilator-acquired pneumonia appears as the primary cause of respiratory worsening, and several studies have already focused on their incidence and prevention. However, studies on the benefits of antibiotic therapy or antibiotic prophylaxis for early pulmonary infections are of tricky analysis, particularly when they do not consider respiratory condition or mortality for their primary outcome measure.
A new definition of complications associated with mechanical ventilation (VAEs) has been established by the Centers for Disease Control and Prevention (CDC) since 2013. It offers a more relevant tool for monitoring the impact of preventive measures on morbidity and mortality, with a more objective definition that goes beyond just tracking ventilator-associated pneumonia.
Several studies have since analyzed the incidence and impact of VAEs on cohorts of intensive care patients, confirming the association between VAEs and morbidity and mortality. However, to our knowledge, none have targeted a population of cardiac arrest survivors.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ventilator associated event | Other | Measure of incidence of Ventilator associated event |
| Measure | Description | Time Frame |
|---|---|---|
| number | Incidence of ventilator associated event | at day 28 |
| Measure | Description | Time Frame |
|---|---|---|
| Associated factors | Associated factors of ventilator associated event | at day 28 |
| number of pneumonias | Ventilator associated pneumonia according to the American Thoracic Society definition |
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Inclusion Criteria:
Exclusion Criteria
- patients who opposed to the use of their data
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Patient admitted to intensive care unit after cardiac arrest at the South Francilien Hospital Center from January 2019 to December 2023
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fabrice COOK, MD | Contact | 01 61 69 52 28 | fabrice.cook@chsf.fr | |
| Caroline TOURTE | Contact | 01 61 69 31 50 | caroline.tourte@chsf.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Sud Francilien | Recruiting | Corbeil-Essonnes | 91106 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15699079 | Background | American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416. doi: 10.1164/rccm.200405-644ST. No abstract available. | |
| 21816940 | Background |
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| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| D053717 | Pneumonia, Ventilator-Associated |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D000077299 | Healthcare-Associated Pneumonia |
| D003428 | Cross Infection |
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| at day 28 |
| time | Mechanical ventilation duration | at day 28 |
| number of deaths | In-hospital mortality | at day 28 |
| Perbet S, Mongardon N, Dumas F, Bruel C, Lemiale V, Mourvillier B, Carli P, Varenne O, Mira JP, Wolff M, Cariou A. Early-onset pneumonia after cardiac arrest: characteristics, risk factors and influence on prognosis. Am J Respir Crit Care Med. 2011 Nov 1;184(9):1048-54. doi: 10.1164/rccm.201102-0331OC. |
| D007239 | Infections |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D007049 | Iatrogenic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |