Fatores de risco para pneumonia associada à ventilação mecânica: Revisão de escopo

Autores

DOI:

https://doi.org/10.33448/rsd-v11i5.28126

Palavras-chave:

Pneumonia associada ao ventilador; Unidades de Terapia Intensiva; Fatores de risco; Pneumonia nosocomial; Infecção hospitalar; Ventilação mecânica.

Resumo

O objetivo do estudo foi identificar e sintetizar a literatura sobre os fatores de risco para Pneumonia Associada à Ventilação Mecânica em pacientes internados em Unidades de Terapia Intensiva. Trata-se de uma revisão da literatura do tipo Revisão de Escopo conforme orientações propostas pelo Joanna Briggs Institute e seguindo por base o direcionamento do PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Identificou-se 23 fatores de risco para evolução de Pneumonia associada à ventilação mecânica. Os principais fatores identificados incluem: maior tempo de internação hospitalar, abordagem à via aérea, tempo em ventilação mecânica invasiva, gravidade da doença primária e uso prolongado de antibióticos. Quanto aos níveis de evidências, o nível 3, predominou dentre as produções e apenas um estudo desenvolvido com modelo experimental. Dessa forma, conclui-se que é necessário a realização de ensaios clínicos que possam elucidar, diante da abordagem de comparação intergrupos, os diferentes fatores de risco, bem como avaliar os possíveis fatores de proteção ao desenvolvimento de Pneumonia associada à ventilação Mecânica.

Biografia do Autor

Washington da Silva Santos, Universidade Estadual do Sudoeste da Bahia

Professor Adjunto 

Referências

Abuabara, A., Weinzierl, G., Artur, W., & Weinzier, J. (2014). Antissepsia Bucal Com Clorexidina Para Prevenir A Pneumonia Associada à Ventilação Mecânica: Revisão E Estudo De Custos Oral Decontamination With Chlorhexidine To Prevent Ventilator-Associated Pneumonia: Review And Study Of Costs. In Revista Eletrônica Gestão & Saúde (Vol. 05).

ANVISA. (2017). Critérios Diagnósticos de Infecção Relacionada à Assistência à Saúde. Anvisa. www.anvisa.gov.br

Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology: Theory and Practice, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616

Arumugam, S. K., Mudali, I., Strandvik, G., El-Menyar, A., Al-Hassani, A., & Al-Thani, H. (2018). Risk factors for ventilator-associated pneumonia in trauma patients: A descriptive analysis. World Journal of Emergency Medicine, 9(3), 203. https://doi.org/10.5847/wjem.j.1920-8642.2018.03.007

Chicayban, L. M., Souza Terra, É. L. V., Ribela, J. dos S., & Barbosa, P. F. (2017). Bundles De Prevenção De Pneumonia Associada À Ventilação Mecânica: A Importância Da Multidisciplinaridade. Biológicas & Saúde, 7(25). https://doi.org/10.25242/886872520171200

Čiginskienė, A., Dambrauskienė, A., Rello, J., & Adukauskienė, D. (2019). Ventilator-associated pneumonia due to drug-resistant acinetobacter baumannii: Risk factors and mortality relation with resistance profiles, and independent predictors of in-hospital mortality. Medicina (Lithuania), 55(2). https://doi.org/10.3390/medicina55020049

Costa, B. H. S., Dias, T. D. K. C., da Paz, M. S. S., dos Santos, C. R., de Oliveira, T. C., Marinho, H. L. M., de Barros Silva Júnior, J. N., & dos Santos Guedes, H. C. (2018). Fatores de risco que favorecem a pneumonia associada à ventilação mecânica. Revista de Enfermagem UFPE on Line, 12(12), 3401. https://doi.org/10.5205/1981-8963-v12i12a235025p3401-3415-2018

Decelle, L., Thys, F., Zech, F., & Verschuren, F. (2013). Ventilation-associated pneumonia after intubation in the prehospital or the emergency unit. European Journal of Emergency Medicine, 20(1), 61–63. https://doi.org/10.1097/MEJ.0b013e3283501677

Dunham, C. M., & Chirichella, T. J. (2011). Attenuated hypocholesterolemia following severe trauma signals risk for late ventilator-associated pneumonia, ventilator dependency, and death: A retrospective study of consecutive patients. Lipids in Health and Disease, 10. https://doi.org/10.1186/1476-511X-10-42

Esnault, P., Nguyen, C., Bordes, J., D’Aranda, E., Montcriol, A., Contargyris, C., Cotte, J., Goutorbe, P., Joubert, C., Dagain, A., Boret, H., & Meaudre, E. (2017). Early-Onset Ventilator-Associated Pneumonia in Patients with Severe Traumatic Brain Injury: Incidence, Risk Factors, and Consequences in Cerebral Oxygenation and Outcome. Neurocritical Care, 27(2), 187–198. https://doi.org/10.1007/s12028-017-0397-4

Forel, J. M., Voillet, F., Pulina, D., Gacouin, A., Perrin, G., Barrau, K., Jaber, S., Arnal, J. M., Fathallah, M., Auquier, P., Roch, A., Azoulay, E., & Papazian, L. (2012). Ventilator-associated pneumonia and ICU mortality in severe ARDS patients ventilated according to a lung-protective strategy. Critical Care, 16(2). https://doi.org/10.1186/cc11312

Hashemian, M., Talaie, H., Akbarpour, S., Mahdavinejad, A., & Mozafari, N. (2016). Central nervous system depressants poisoning and ventilator associated pneumonia: An underrated risk factor at the toxicological intensive care unit. Iranian Red Crescent Medical Journal, 18(1). https://doi.org/10.5812/ircmj.30989

Houard, M., Rouzé, A., Ledoux, G., Six, S., Jaillette, E., Poissy, J., Préau, S., Wallet, F., Labreuche, J., Nseir, S., & Voisin, B. (2018a). Relationship between digestive tract colonization and subsequent ventilator-associated pneumonia related to ESBL-producing Enterobacteriaceae. PLoS ONE, 13(8). https://doi.org/10.1371/journal.pone.0201688

Hunter, J. D. (2006). Ventilator associated pneumonia. In Postgraduate Medical Journal (Vol. 82, Issue 965, pp. 172–178). https://doi.org/10.1136/pgmj.2005.036905

Ibn Saied, W., Souweine, B., Garrouste-Orgeas, M., Ruckly, S., Darmon, M., Bailly, S., Cohen, Y., Azoulay, E., Schwebel, C., Radjou, A., Kallel, H., Adrie, C., Dumenil, A.-S., Argaud, L., Marcotte, G., Jamali, S., Papazian, L., Goldgran-Toledano, D., Bouadma, L., & Timsit, J.-F. (2017). Respective impact of implementation of prevention strategies, colonization with multiresistant bacteria and antimicrobial use on the risk of early- and late-onset VAP: An analysis of the OUTCOMEREA network. PLOS ONE, 12(11), e0187791. https://doi.org/10.1371/journal.pone.0187791

Ismaeil, T., Alfunaysan, L., Alotaibi, N., Alkadi, S., & Othman, F. (2019). Repositioning of endotracheal tube and risk of ventilator-Associated pneumonia among adult patients: A matched case-control study. Annals of Thoracic Medicine, 14(4), 264–268. https://doi.org/10.4103/atm.ATM_26_19

Jovanovic, B., Milan, Z., Markovic-Denic, L., Djuric, O., Radinovic, K., Doklestic, K., Velickovic, J., Ivancevic, N., Gregoric, P., Pandurovic, M., Bajec, D., & Bumbasirevic, V. (2015). Risk factors for ventilator-associated pneumonia in patients with severe traumatic brain injury in a Serbian trauma centre. International Journal of Infectious Diseases, 38, 46–51. https://doi.org/10.1016/j.ijid.2015.07.005

Karatas, M., Saylan, S., Kostakoglu, U., & Yilmaz, G. (2016). An assessment of ventilator-associated pneumonias and risk factors identified in the intensive care unit. Pakistan Journal of Medical Sciences, 32(4), 817–822. https://doi.org/10.12669/pjms.324.10381

Koulenti, D., Parisella, F. R., Xu, E., Lipman, J., & Rello, J. (2019). The relationship between ventilator-associated pneumonia and chronic obstructive pulmonary disease: what is the current evidence? In European Journal of Clinical Microbiology and Infectious Diseases (Vol. 38, Issue 4, pp. 637–647). Springer Verlag. https://doi.org/10.1007/s10096-019-03486-2

Kózka, M., Sega, A., Wojnar-Gruszka, K., Tarnawska, A., & Gniadek, A. (2020). Risk factors of pneumonia associated with mechanical ventilation. International Journal of Environmental Research and Public Health, 17(2). https://doi.org/10.3390/ijerph17020656

Li, Y., Liu, C., Xiao, W., Song, T., & Wang, S. (2020). Incidence, Risk Factors, and Outcomes of Ventilator-Associated Pneumonia in Traumatic Brain Injury: A Meta-analysis. In Neurocritical Care (Vol. 32, Issue 1, pp. 272–285). Springer. https://doi.org/10.1007/s12028-019-00773-w

Liu, Y., Di, Y., & Fu, S. (2017). Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgery for head and neck cancer. Frontiers of Medicine, 11(2), 239–246. https://doi.org/10.1007/s11684-017-0509-8

Maia, I. S., Maria, M., Silva, D. M., & Costa, S. (2007). Diretrizes brasileiras para tratamento das pneumonias adquiridas no hospital e das associadas à ventilação mecânica - 2007. Jornal Brasileiro de Pneumologia, 33 (Supl 1(79), 1–30.

Moreira, M. R., & Gontijo Filho, P. P. (2012). Relationship between antibiotic consumption, oropharyngeal colonization, and ventilator-associated pneumonia by Staphylococcus aureus in an intensive care unit of a Brazilian teaching hospital. Revista Da Sociedade Brasileira de Medicina Tropical, 45(1), 106–111. https://doi.org/10.1590/s0037-86822012000100020

Mota, É. C., Oliveira, S. P., Silveira, B. R. M., Silva, P. L. N., & Oliveira, A. C. (2017). Incidência da pneumonia associada à ventilação mecânica em unidade de terapia intensive. Medicina (Brazil), 50(1), 39–46. https://doi.org/10.11606/issn.2176-7262.v50i1p39-46

Padilla, A. C. H., Trampont, T., Lafon, T., Daix, T., Cailloce, D., Barraud, O., Dalmay, F., Vignon, P., & François, B. (2019). Is prehospital endobronchial intubation a risk factor for subsequent ventilator associated pneumonia? A retrospective analysis. PLoS ONE, 14(5). https://doi.org/10.1371/journal.pone.0217466

Park, H. O., Kang, D. H., Moon, S. H., Yang, J. H., Kim, S. H., & Byun, J. H. (2017). Risk factors for pneumonia in ventilated trauma patients with multiple rib fractures. Korean Journal of Thoracic and Cardiovascular Surgery, 50(5), 346–354. https://doi.org/10.5090/kjtcs.2017.50.5.346

Park, S. A., Cho, S. S., & Kwak, G. J. (2014). Factors influencing ventilator-associated pneumonia in cancer patients. Asian Pacific Journal of Cancer Prevention, 15(14), 5787–5791. https://doi.org/10.7314/APJCP.2014.15.14.5787

Ranjan, N., Chaudhary, U., Chaudhry, D., & Ranjan, K. P. (2014). Ventilator-associated pneumonia in a tertiary care intensive care unit: Analysis of incidence, risk factors and mortality. Indian Journal of Critical Care Medicine, 18(4), 200–204. https://doi.org/10.4103/0972-5229.130570

Sachdeva, D., Singh, D., Loomba, P., Kaur, A., Tandon, M., & Bishnoi, I. (2017). Assessment of surgical risk factors in the development of ventilator-associated pneumonia in neurosurgical intensive care unit patients: Alarming observations. Neurology India, 65(4), 779–784. https://doi.org/10.4103/neuroindia.NI_814_16

Saied, W. I., Souweine, B., Garrouste-Orgeas, M., Ruckly, S., Darmon, M., Bailly, S., Cohen, Y., Azoulay, E., Schwebel, C., & Radjou, A. (2018). Respective impact of implementation of prevention strategies, colonization with multiresistant bacteria and antimicrobial use on the risk of early- and late-onset VAP: An analysis of the OUTCOMEREA network. https://doi.org/10.1371/jour

Silva Maia, I., & Antônio Mendonça Guimarães Secretária, F. (n.d.). Regionais da Sociedade Brasileira de Pneumologia e Tisiologia. www.sppt.org.br

Silva, R. M., Silvestre, M. de O., Zocche, T. L., & Sakae, T. M. (2011). Pneumonia associada à ventilação mecânica: fatores de risco. Revista Brasileira de Clinica Medica, 9(1), 5–10. http://files.bvs.br/upload/S/1679-1010/2011/v9n1/a1714.pdf

Six, S., Jaffal, K., Ledoux, G., Jaillette, E., Wallet, F., & Nseir, S. (2016). Hyperoxemia as a risk factor for ventilator-associated pneumonia. Critical Care, 20(1). https://doi.org/10.1186/s13054-016-1368-4

Sociedade Paulista de Infectologia. (2006). Diretrizes sobre Pneumonia associada a Ventilação Mecânica (PaV). Office Editora e Publicidade Ltda.

Tan, X., Zhu, S., Yan, D., Chen, W., Chen, R., Zou, J., Yan, J., Zhang, X., Farmakiotis, D., & Mylonakis, E. (2016). Candida spp. Airway colonization: A potential risk factor for acinetobacter baumannii ventilator-associated pneumonia. Medical Mycology, 54(6), 557–566. https://doi.org/10.1093/mmy/myw009

Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., & Straus, S. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. In Annals of Internal Medicine. 169(7), 467–473. American College of Physicians. https://doi.org/10.7326/M18-0850

Tsakiridou, E., Makris, D., Daniil, Z., Manoulakas, E., Chatzipantazi, V., Vlachos, O., Xidopoulos, G., Charalampidou, O., & Zakynthinos, E. (2014). Acinetobacter baumannii infection in prior ICU bed occupants is an independent risk factor for subsequent cases of ventilator-associated pneumonia. BioMed Research International, 2014. https://doi.org/10.1155/2014/193516

van der Kooi, T. I. I., Boshuizen, H., Wille, J. C., de Greeff, S. C., van Dissel, J. T., Schoffelen, A. F., & van Gaalen, R. D. (2019). Using flexible methods to determine risk factors for ventilator-associated pneumonia in the Netherlands. PLoS ONE, 14(6). https://doi.org/10.1371/journal.pone.0218372

Wolkewitz, M., Palomar-Martinez, M., Alvarez-Lerma, F., Olaechea-Astigarraga, P., & Schumacher, M. (2019). Analyzing the impact of duration of ventilation, hospitalization, and ventilation episodes on the risk of pneumonia. Infection Control and Hospital Epidemiology, 40(3), 301–306. https://doi.org/10.1017/ice.2018.360

Wu, D., Wu, C., Zhang, S., & Zhong, Y. (2019). Risk factors of ventilator-associated pneumonia in critically III patients. In Frontiers in Pharmacology (Vol. 10, Issue MAY). Frontiers Media S.A. https://doi.org/10.3389/fphar.2019.00482

Xu, Y., Lai, C., Xu, G., Meng, W., Zhang, J., Hou, H., & Pi, H. (2019). Risk factors of ventilator-associated pneumonia in elderly patients receiving mechanical ventilation. Clinical Interventions in Aging, 14, 1027–1038. https://doi.org/10.2147/CIA.S197146

Downloads

Publicado

09/04/2022

Como Citar

SANTOS, M. S. .; SANTOS, W. da S. .; SANTANA, T. dos S. .; SANTANA, V. D. . Fatores de risco para pneumonia associada à ventilação mecânica: Revisão de escopo. Research, Society and Development, [S. l.], v. 11, n. 5, p. e33111528126, 2022. DOI: 10.33448/rsd-v11i5.28126. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/28126. Acesso em: 21 nov. 2024.

Edição

Seção

Ciências da Saúde