Is COPD associated with increased risk for microaspiration in intubated critically ill patients? - 08/01/26
for the MicroCOPD study group
Emmanuelle Mercier, Pierre-Louis Declercq, Michel Sirodot, Gaël Piton, François Tinturier, Elisabeth Coupez, Stéphane Gaudry, Michel Djibré, Didier Thévenin, Céline Broucqsault-Dedrie, Stéphanie Barrailler, Cyril Fayolle, Franck Minacori, Isabelle Alves
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Background |
Although COPD patients are at higher risk for aspiration when breathing spontaneously, no information is available on the risk for microaspiration in invasively ventilated COPD patients. The aim of our study was to determine the relationship between COPD and abundant microaspiration in intubated critically ill patients.
Methods |
This was a retrospective analysis of prospectively collected data, provided by 3 randomized controlled trials on microaspiration in critically ill patients receiving invasive mechanical ventilation for more than 48 h. Abundant microaspiration was defined as the presence of pepsin and or alpha-amylase at significant levels in tracheal aspirates. In all study patients, pepsin and alpha-amylase were quantitatively measured in all tracheal aspirates collected during a 48-h period. COPD was defined using spirometry criteria.
Results |
Among the 515 included patients, 70 (14%) had proven COPD. Pepsin and alpha-amylase were quantitatively measured in 3873 and 3764 tracheal aspirates, respectively. No significant difference was found in abundant microaspiration rate between COPD and non-COPD patients (62 of 70 patients (89%) vs 366 of 445 (82%) patients, p = 0.25). Similarly, no significant difference was found in abundant microaspiration of gastric contents (53% vs 45%, p = 0.28), oropharyngeal secretions (71% vs 71%, p = 0.99), or VAP (19% vs 22%, p = 0.65) rates between the two groups. No significant difference was found between COPD and non-COPD patients in duration of mechanical ventilation, ICU length of stay, or ICU mortality.
Conclusions |
Our results suggest that COPD is not associated with increased risk for abundant microaspiration in intubated critically ill patients.
Le texte complet de cet article est disponible en PDF.Keywords : COPD, Intubation, Mechanical ventilation, Microaspiration, Pneumonia
Keywords : Medical and Health Sciences, Clinical Sciences
Plan
Vol 11 - N° 1
Article 7- 2021 Retour au numéro
Article précédent
- Inter-hospital transport of critically ill patients to manage the intensive care unit surge during the COVID-19 pandemic in France
- Benoit Painvin, Hélène Messet, Maeva Rodriguez, Thomas Lebouvier, Delphine Chatellier, Louis Soulat, Stephane Ehrmann, Arnaud W. Thille, Arnaud Gacouin, Jean-Marc Tadie
- Reliability of the Clinical Frailty Scale in very elderly ICU patients: a prospective European study
- Hans Flaatten, Bertrand Guidet, Finn H. Andersen, Antonio Artigas, Maurizio Cecconi, Ariane Boumendil, Muhammed Elhadi, Jesper Fjølner, Michael Joannidis, Christian Jung, Susannah Leaver, Brian Marsh, Rui Moreno, Sandra Oeyen, Yuriy Nalapko, Joerg C. Schefold, Wojciech Szczeklik, Sten Walther, Ximena Watson, Tilemachos Zafeiridis, Dylan W. de Lange, the VIP2 Study Group
Bienvenue sur EM-consulte, la référence des professionnels de santé.