Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies: A Narrative Review
<i>Background and Objectives</i>: Ventilator-associated pneumonia (VAP) poses a significant threat to the clinical outcomes and hospital stays of mechanically ventilated patients, particularly those recovering from cardiac arrest. Given the already elevated mortality rates in cardiac arr...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/61/1/78 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832587997362520064 |
|---|---|
| author | Harinivaas Shanmugavel Geetha Yi Xiang Teo Sharmitha Ravichandran Amos Lal |
| author_facet | Harinivaas Shanmugavel Geetha Yi Xiang Teo Sharmitha Ravichandran Amos Lal |
| author_sort | Harinivaas Shanmugavel Geetha |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Ventilator-associated pneumonia (VAP) poses a significant threat to the clinical outcomes and hospital stays of mechanically ventilated patients, particularly those recovering from cardiac arrest. Given the already elevated mortality rates in cardiac arrest cases, the addition of VAP further diminishes the chances of survival. Consequently, a paramount focus on VAP prevention becomes imperative. This review endeavors to comprehensively delve into the nuances of VAP, specifically in patients requiring mechanical ventilation in post-cardiac arrest care. The overarching objectives encompass (I) exploring the etiology, risk factors, and pathophysiology of VAP, (II) delving into available diagnostic modalities, and (III) providing insights into the management options and recent treatment guidelines. <i>Methods</i>: A literature search was conducted using PubMed, MEDLINE, and Google Scholar databases for articles about VAP and Cardiac arrest. We used the MeSH terms “VAP”, “Cardiac arrest”, “postcardiac arrest syndrome”, and “postcardiac arrest syndrome”. The clinical presentation, diagnostic, and management strategies of VAP were summarized, and all authors reviewed the selection and decided which studies to include. <i>Key Content and Findings</i>: The incidence and mortality rates of VAP exhibit significant variability, yet a recurring pattern emerges, marked by prolonged hospitalization and exacerbated clinical outcomes. This pattern is attributed to the elevated incidence of drug-resistant infections and the delayed initiation of antimicrobial treatment. This review focuses on VAP, aiming to offer valuable insights into the efficient identification and management of this fatal complication in post-cardiac arrest patients. <i>Conclusion</i>: The prognosis for survival after cardiac arrest is already challenging, and the outlook becomes even more daunting when complicated by VAP. The timely diagnosis of VAP and initiation of antibiotics pose considerable challenges, primarily due to the invasive nature of obtaining high-quality samples and the time required for speciation and identification of antimicrobial sensitivity. The controversy surrounding prophylactic antibiotics persists, but promising new strategies have been proposed; however, they are still awaiting well-designed clinical trials. |
| format | Article |
| id | doaj-art-6dc070287abb40f381c06495ab268591 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-6dc070287abb40f381c06495ab2685912025-01-24T13:40:30ZengMDPI AGMedicina1010-660X1648-91442025-01-016117810.3390/medicina61010078Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies: A Narrative ReviewHarinivaas Shanmugavel Geetha0Yi Xiang Teo1Sharmitha Ravichandran2Amos Lal3Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, USADivision of Pulmonary and Critical Care Medicine, UMass-Baystate Hospital, Springfield, MA 01107, USADepartment of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, USADivision of Pulmonary and Critical Care Medicine Mayo Clinic, Rochester, MN 55905, USA<i>Background and Objectives</i>: Ventilator-associated pneumonia (VAP) poses a significant threat to the clinical outcomes and hospital stays of mechanically ventilated patients, particularly those recovering from cardiac arrest. Given the already elevated mortality rates in cardiac arrest cases, the addition of VAP further diminishes the chances of survival. Consequently, a paramount focus on VAP prevention becomes imperative. This review endeavors to comprehensively delve into the nuances of VAP, specifically in patients requiring mechanical ventilation in post-cardiac arrest care. The overarching objectives encompass (I) exploring the etiology, risk factors, and pathophysiology of VAP, (II) delving into available diagnostic modalities, and (III) providing insights into the management options and recent treatment guidelines. <i>Methods</i>: A literature search was conducted using PubMed, MEDLINE, and Google Scholar databases for articles about VAP and Cardiac arrest. We used the MeSH terms “VAP”, “Cardiac arrest”, “postcardiac arrest syndrome”, and “postcardiac arrest syndrome”. The clinical presentation, diagnostic, and management strategies of VAP were summarized, and all authors reviewed the selection and decided which studies to include. <i>Key Content and Findings</i>: The incidence and mortality rates of VAP exhibit significant variability, yet a recurring pattern emerges, marked by prolonged hospitalization and exacerbated clinical outcomes. This pattern is attributed to the elevated incidence of drug-resistant infections and the delayed initiation of antimicrobial treatment. This review focuses on VAP, aiming to offer valuable insights into the efficient identification and management of this fatal complication in post-cardiac arrest patients. <i>Conclusion</i>: The prognosis for survival after cardiac arrest is already challenging, and the outlook becomes even more daunting when complicated by VAP. The timely diagnosis of VAP and initiation of antibiotics pose considerable challenges, primarily due to the invasive nature of obtaining high-quality samples and the time required for speciation and identification of antimicrobial sensitivity. The controversy surrounding prophylactic antibiotics persists, but promising new strategies have been proposed; however, they are still awaiting well-designed clinical trials.https://www.mdpi.com/1648-9144/61/1/78ventilator-associated pneumonia (VAP)hospital-acquired pneumonia (HAP)cardiac arrest |
| spellingShingle | Harinivaas Shanmugavel Geetha Yi Xiang Teo Sharmitha Ravichandran Amos Lal Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies: A Narrative Review Medicina ventilator-associated pneumonia (VAP) hospital-acquired pneumonia (HAP) cardiac arrest |
| title | Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies: A Narrative Review |
| title_full | Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies: A Narrative Review |
| title_fullStr | Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies: A Narrative Review |
| title_full_unstemmed | Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies: A Narrative Review |
| title_short | Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies: A Narrative Review |
| title_sort | ventilator associated pneumonia after cardiac arrest and prevention strategies a narrative review |
| topic | ventilator-associated pneumonia (VAP) hospital-acquired pneumonia (HAP) cardiac arrest |
| url | https://www.mdpi.com/1648-9144/61/1/78 |
| work_keys_str_mv | AT harinivaasshanmugavelgeetha ventilatorassociatedpneumoniaaftercardiacarrestandpreventionstrategiesanarrativereview AT yixiangteo ventilatorassociatedpneumoniaaftercardiacarrestandpreventionstrategiesanarrativereview AT sharmitharavichandran ventilatorassociatedpneumoniaaftercardiacarrestandpreventionstrategiesanarrativereview AT amoslal ventilatorassociatedpneumoniaaftercardiacarrestandpreventionstrategiesanarrativereview |