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Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration

Previous studies have identified cirrhosis as a risk factor for ventilator-associated pneumonia (VAP). The aim of our study was to determine the relationship between cirrhosis and abundant gastric-content microaspiration in intubated critically ill patients. We performed a matched cohort study using...

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Autores principales: Levy, Clementine, Gaudet, Alexandre, Jaillette, Emmanuelle, Reignier, Jean, Lassailly, Guillaume, Balduyck, Malika, Cailliau, Emeline, Rouze, Anahita, Nseir, Saad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604551/
https://www.ncbi.nlm.nih.gov/pubmed/36294314
http://dx.doi.org/10.3390/jcm11205994
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author Levy, Clementine
Gaudet, Alexandre
Jaillette, Emmanuelle
Reignier, Jean
Lassailly, Guillaume
Balduyck, Malika
Cailliau, Emeline
Rouze, Anahita
Nseir, Saad
author_facet Levy, Clementine
Gaudet, Alexandre
Jaillette, Emmanuelle
Reignier, Jean
Lassailly, Guillaume
Balduyck, Malika
Cailliau, Emeline
Rouze, Anahita
Nseir, Saad
author_sort Levy, Clementine
collection PubMed
description Previous studies have identified cirrhosis as a risk factor for ventilator-associated pneumonia (VAP). The aim of our study was to determine the relationship between cirrhosis and abundant gastric-content microaspiration in intubated critically ill patients. We performed a matched cohort study using data from three randomized controlled trials on abundant microaspiration in patients under mechanical ventilation. Each cirrhotic patient was matched with three to four controls for gender, age ± 5 years and simplified acute physiology score II (SAPS II) ± 5 points. Abundant microaspiration was defined by significant levels of pepsin and alpha-amylase in >30% of tracheal aspirates. All tracheal aspirates were collected for the first 48 h of the study period. The percentage of patients with abundant gastric-content microaspiration was the primary outcome. The abundant microaspiration of oropharyngeal secretions, VAP incidence, the duration of mechanical ventilation, length of intensive care unit (ICU) stay and mortality were the secondary outcomes. A. total of 39 cirrhotic patients were matched to 138 controls. The percentage of patients with abundant gastric-content microaspiration did not differ between the two groups (relative risk: 0.91 (95% CI: 0.75 to 1.10)). There was no significant difference between the two groups in terms of the abundant microaspiration of oropharyngeal secretions, VAP, the duration of mechanical ventilation, the length of ICU stay and mortality. Our results suggest that cirrhosis is not associated with abundant gastric-content microaspiration.
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spelling pubmed-96045512022-10-27 Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration Levy, Clementine Gaudet, Alexandre Jaillette, Emmanuelle Reignier, Jean Lassailly, Guillaume Balduyck, Malika Cailliau, Emeline Rouze, Anahita Nseir, Saad J Clin Med Article Previous studies have identified cirrhosis as a risk factor for ventilator-associated pneumonia (VAP). The aim of our study was to determine the relationship between cirrhosis and abundant gastric-content microaspiration in intubated critically ill patients. We performed a matched cohort study using data from three randomized controlled trials on abundant microaspiration in patients under mechanical ventilation. Each cirrhotic patient was matched with three to four controls for gender, age ± 5 years and simplified acute physiology score II (SAPS II) ± 5 points. Abundant microaspiration was defined by significant levels of pepsin and alpha-amylase in >30% of tracheal aspirates. All tracheal aspirates were collected for the first 48 h of the study period. The percentage of patients with abundant gastric-content microaspiration was the primary outcome. The abundant microaspiration of oropharyngeal secretions, VAP incidence, the duration of mechanical ventilation, length of intensive care unit (ICU) stay and mortality were the secondary outcomes. A. total of 39 cirrhotic patients were matched to 138 controls. The percentage of patients with abundant gastric-content microaspiration did not differ between the two groups (relative risk: 0.91 (95% CI: 0.75 to 1.10)). There was no significant difference between the two groups in terms of the abundant microaspiration of oropharyngeal secretions, VAP, the duration of mechanical ventilation, the length of ICU stay and mortality. Our results suggest that cirrhosis is not associated with abundant gastric-content microaspiration. MDPI 2022-10-11 /pmc/articles/PMC9604551/ /pubmed/36294314 http://dx.doi.org/10.3390/jcm11205994 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Levy, Clementine
Gaudet, Alexandre
Jaillette, Emmanuelle
Reignier, Jean
Lassailly, Guillaume
Balduyck, Malika
Cailliau, Emeline
Rouze, Anahita
Nseir, Saad
Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration
title Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration
title_full Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration
title_fullStr Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration
title_full_unstemmed Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration
title_short Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration
title_sort are cirrhotic patients receiving invasive mechanical ventilation at risk of abundant microaspiration
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604551/
https://www.ncbi.nlm.nih.gov/pubmed/36294314
http://dx.doi.org/10.3390/jcm11205994
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