Naghibi T, Karimi H. The impact of inspiratory pressure level on prevention of ventilator-associated pneumonia: A double-blind, randomized clinical trial.
Am J Med Sci 2023;
365:162-168. [PMID:
36202162 DOI:
10.1016/j.amjms.2022.07.020]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/19/2022] [Accepted: 07/14/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND
Atelectasis and pneumonia are highly prevalent in patients under mechanical ventilation. Studies indicate that using ventilation with an open lung concept improves recovery, decreases ventilator-related pneumonia, decreases mortality and leads to faster weaning from the ventilator. Therefore, this study investigated the effect of higher airway pressure on ventilator-associated pneumonia.
METHODS
This randomized clinical trial was conducted on 120 patients under mechanical ventilation. The patients were divided into two groups based on ventilator pressure: the control group (pressure level 20) and the intervention group (pressure level 30). Demographic data, disease severity, the incidence of ventilator-associated pneumonia, organ damage, days connected to the ventilator, length of hospitalization in ICU, and mortality were compared between the two groups.
RESULTS
There was no significant difference in demographic data and disease severity between the two groups. The average Clinical Pulmonary Infection Score in the intervention group was significantly lower than the control group (P = 0.02). The intervention group's average Sequential Organ Failure Assessment score was significantly lower than the control group (p = 0.016).
CONCLUSIONS
High-pressure levels can decrease ventilator-associated pneumonia and organ failure. It is recommended that the study be repeated with a larger, more diverse population.
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