Pneumonie acquise sous ventilation mécanique chez le patient BPCO : épidémiologie, physiopathologie, prévention

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• 作者：A. Rouze ; S. Nseir
• 关键词：Bronchopneumopathie chronique obstructive ; Pneumonie acquise sous ventilation mécanique ; Ventilation mécanique ; Colonisation trachéobronchique ; Microinhalations ; Reflux gastro ; ?sophagien ; Chronic obstructive pulmonary disease ; Ventilator ; associated pneumonia ; Mechanical ventilation ; Lower respiratory tract colonization ; Microaspiration ; Gastro ; esophageal reflux
• 刊名：R篓娄animation
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：24
• 期：3
• 页码：295-302
• 全文大小：295 KB
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• 作者单位：A. Rouze (1)
  S. Nseir (1) (2)
  
  1. Centre de réanimation, h?pital Roger Salengro, CHRU, boulevard du Pr Leclercq, F-59037, Lille cedex, France
  2. EA 2694, Université Lille 2, place de Verdun, F-59045, Lille cedex, France
  
• 刊物主题：Emergency Medicine; Anesthesiology; Intensive / Critical Care Medicine;
• 出版者：Springer Paris
• ISSN：1951-6959

文摘

Chronic obstructive pulmonary disease (COPD) promotes the development of ventilator- associated pneumonia (VAP) in critically ill patients. Specific risk factors for VAP in this particular population include prolonged invasive mechanical ventilation, increased tracheobronchial bacterial colonization, and altered local and general host defense mechanisms. Invasive mechanical ventilation of COPD patients is still a frequent situation in intensive care, despite the increasing use of non invasive ventilation (NIV) during the last two decades. COPD is identified as an independent risk factor for VAP in several epidemiological studies. Higher mortality and durations of mechanical ventilation and ICU stay have been reported in COPD patients who develop VAP. NIV may be considered as the main preventive strategy for VAP occurrence in COPD patients. Future studies should focus on specific preventive measures in this high risk population.