Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study

Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Ignacio Martin-Loeches [verfasserIn] Adrian Ceccato [verfasserIn] Marco Carbonara [verfasserIn] Gianluigi li Bassi [verfasserIn] Pierluigi di Natale [verfasserIn] Stefano Nogas [verfasserIn] Otavio Ranzani [verfasserIn] Carla Speziale [verfasserIn] Tarek Senussi [verfasserIn] Francesco Idone [verfasserIn] Anna Motos [verfasserIn] Miquel Ferrer [verfasserIn] Antoni Torres [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	VAP pneumonia shock antibiotics ICUAP

Übergeordnetes Werk:	In: Antibiotics - MDPI AG, 2013, 10(2021), 7, p 798
Übergeordnetes Werk:	volume:10 ; year:2021 ; number:7, p 798

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/antibiotics10070798

Katalog-ID:	DOAJ071191895

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520			\|a Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes.
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allfields	10.3390/antibiotics10070798 doi (DE-627)DOAJ071191895 (DE-599)DOAJ58af9d5e552c46f3815ae4c53eb1ac48 DE-627 ger DE-627 rakwb eng RM1-950 Ignacio Martin-Loeches verfasserin aut Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes. VAP pneumonia shock antibiotics ICUAP Therapeutics. Pharmacology Adrian Ceccato verfasserin aut Marco Carbonara verfasserin aut Gianluigi li Bassi verfasserin aut Pierluigi di Natale verfasserin aut Stefano Nogas verfasserin aut Otavio Ranzani verfasserin aut Carla Speziale verfasserin aut Tarek Senussi verfasserin aut Francesco Idone verfasserin aut Anna Motos verfasserin aut Miquel Ferrer verfasserin aut Antoni Torres verfasserin aut In Antibiotics MDPI AG, 2013 10(2021), 7, p 798 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:10 year:2021 number:7, p 798 https://doi.org/10.3390/antibiotics10070798 kostenfrei https://doaj.org/article/58af9d5e552c46f3815ae4c53eb1ac48 kostenfrei https://www.mdpi.com/2079-6382/10/7/798 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 7, p 798
spelling	10.3390/antibiotics10070798 doi (DE-627)DOAJ071191895 (DE-599)DOAJ58af9d5e552c46f3815ae4c53eb1ac48 DE-627 ger DE-627 rakwb eng RM1-950 Ignacio Martin-Loeches verfasserin aut Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes. VAP pneumonia shock antibiotics ICUAP Therapeutics. Pharmacology Adrian Ceccato verfasserin aut Marco Carbonara verfasserin aut Gianluigi li Bassi verfasserin aut Pierluigi di Natale verfasserin aut Stefano Nogas verfasserin aut Otavio Ranzani verfasserin aut Carla Speziale verfasserin aut Tarek Senussi verfasserin aut Francesco Idone verfasserin aut Anna Motos verfasserin aut Miquel Ferrer verfasserin aut Antoni Torres verfasserin aut In Antibiotics MDPI AG, 2013 10(2021), 7, p 798 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:10 year:2021 number:7, p 798 https://doi.org/10.3390/antibiotics10070798 kostenfrei https://doaj.org/article/58af9d5e552c46f3815ae4c53eb1ac48 kostenfrei https://www.mdpi.com/2079-6382/10/7/798 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 7, p 798
allfields_unstemmed	10.3390/antibiotics10070798 doi (DE-627)DOAJ071191895 (DE-599)DOAJ58af9d5e552c46f3815ae4c53eb1ac48 DE-627 ger DE-627 rakwb eng RM1-950 Ignacio Martin-Loeches verfasserin aut Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes. VAP pneumonia shock antibiotics ICUAP Therapeutics. Pharmacology Adrian Ceccato verfasserin aut Marco Carbonara verfasserin aut Gianluigi li Bassi verfasserin aut Pierluigi di Natale verfasserin aut Stefano Nogas verfasserin aut Otavio Ranzani verfasserin aut Carla Speziale verfasserin aut Tarek Senussi verfasserin aut Francesco Idone verfasserin aut Anna Motos verfasserin aut Miquel Ferrer verfasserin aut Antoni Torres verfasserin aut In Antibiotics MDPI AG, 2013 10(2021), 7, p 798 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:10 year:2021 number:7, p 798 https://doi.org/10.3390/antibiotics10070798 kostenfrei https://doaj.org/article/58af9d5e552c46f3815ae4c53eb1ac48 kostenfrei https://www.mdpi.com/2079-6382/10/7/798 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 7, p 798
allfieldsGer	10.3390/antibiotics10070798 doi (DE-627)DOAJ071191895 (DE-599)DOAJ58af9d5e552c46f3815ae4c53eb1ac48 DE-627 ger DE-627 rakwb eng RM1-950 Ignacio Martin-Loeches verfasserin aut Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes. VAP pneumonia shock antibiotics ICUAP Therapeutics. Pharmacology Adrian Ceccato verfasserin aut Marco Carbonara verfasserin aut Gianluigi li Bassi verfasserin aut Pierluigi di Natale verfasserin aut Stefano Nogas verfasserin aut Otavio Ranzani verfasserin aut Carla Speziale verfasserin aut Tarek Senussi verfasserin aut Francesco Idone verfasserin aut Anna Motos verfasserin aut Miquel Ferrer verfasserin aut Antoni Torres verfasserin aut In Antibiotics MDPI AG, 2013 10(2021), 7, p 798 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:10 year:2021 number:7, p 798 https://doi.org/10.3390/antibiotics10070798 kostenfrei https://doaj.org/article/58af9d5e552c46f3815ae4c53eb1ac48 kostenfrei https://www.mdpi.com/2079-6382/10/7/798 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 7, p 798
allfieldsSound	10.3390/antibiotics10070798 doi (DE-627)DOAJ071191895 (DE-599)DOAJ58af9d5e552c46f3815ae4c53eb1ac48 DE-627 ger DE-627 rakwb eng RM1-950 Ignacio Martin-Loeches verfasserin aut Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes. VAP pneumonia shock antibiotics ICUAP Therapeutics. Pharmacology Adrian Ceccato verfasserin aut Marco Carbonara verfasserin aut Gianluigi li Bassi verfasserin aut Pierluigi di Natale verfasserin aut Stefano Nogas verfasserin aut Otavio Ranzani verfasserin aut Carla Speziale verfasserin aut Tarek Senussi verfasserin aut Francesco Idone verfasserin aut Anna Motos verfasserin aut Miquel Ferrer verfasserin aut Antoni Torres verfasserin aut In Antibiotics MDPI AG, 2013 10(2021), 7, p 798 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:10 year:2021 number:7, p 798 https://doi.org/10.3390/antibiotics10070798 kostenfrei https://doaj.org/article/58af9d5e552c46f3815ae4c53eb1ac48 kostenfrei https://www.mdpi.com/2079-6382/10/7/798 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 7, p 798
language	English
source	In Antibiotics 10(2021), 7, p 798 volume:10 year:2021 number:7, p 798
sourceStr	In Antibiotics 10(2021), 7, p 798 volume:10 year:2021 number:7, p 798
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	VAP pneumonia shock antibiotics ICUAP Therapeutics. Pharmacology
isfreeaccess_bool	true
container_title	Antibiotics
authorswithroles_txt_mv	Ignacio Martin-Loeches @@aut@@ Adrian Ceccato @@aut@@ Marco Carbonara @@aut@@ Gianluigi li Bassi @@aut@@ Pierluigi di Natale @@aut@@ Stefano Nogas @@aut@@ Otavio Ranzani @@aut@@ Carla Speziale @@aut@@ Tarek Senussi @@aut@@ Francesco Idone @@aut@@ Anna Motos @@aut@@ Miquel Ferrer @@aut@@ Antoni Torres @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
hierarchy_top_id	726120596
id	DOAJ071191895
language_de	englisch
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callnumber-first	R - Medicine
author	Ignacio Martin-Loeches
spellingShingle	Ignacio Martin-Loeches misc RM1-950 misc VAP misc pneumonia misc shock misc antibiotics misc ICUAP misc Therapeutics. Pharmacology Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study
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topic_title	RM1-950 Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study VAP pneumonia shock antibiotics ICUAP
topic	misc RM1-950 misc VAP misc pneumonia misc shock misc antibiotics misc ICUAP misc Therapeutics. Pharmacology
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title	Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study
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title_full	Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study
author_sort	Ignacio Martin-Loeches
journal	Antibiotics
journalStr	Antibiotics
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author_browse	Ignacio Martin-Loeches Adrian Ceccato Marco Carbonara Gianluigi li Bassi Pierluigi di Natale Stefano Nogas Otavio Ranzani Carla Speziale Tarek Senussi Francesco Idone Anna Motos Miquel Ferrer Antoni Torres
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title_sort	impact of cardiovascular failure in intensive care unit-acquired pneumonia: a single-center, prospective study
callnumber	RM1-950
title_auth	Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study
abstract	Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes.
abstractGer	Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes.
abstract_unstemmed	Background: Cardiovascular failure (CVF) may complicate intensive care unit-acquired pneumonia (ICUAP) and radically alters the empirical treatment of this condition. The aim of this study was to determine the impact of CVF on outcome in patients with ICUAP. Methods: A prospective, single-center, observational study was conducted in six medical and surgical ICUs at a University Hospital. CVS was defined as a score of 3 or more on the cardiovascular component of the Sequential Organ Failure Assessment (SOFA) score. At the onset of ICUAP, CVF was reported as absent, transient (if lasting ≤ 3 days) or persistent (<3 days). The primary outcome was 90-day mortality modelled through a Cox regression analysis. Secondary outcomes were 28-day mortality, hospital mortality, ICU length of stay (LOS) and hospital LOS. Results: 358 patients were enrolled: 203 (57%) without CVF, 82 (23%) with transient CVF, and 73 (20%) with persistent CVF. Patients with transient and persistent CVF were more severely ill and presented higher inflammatory response than those without CVF. Despite having similar severity and aetiology, the persistent CVF group more frequently received inadequate initial antibiotic treatment and presented more treatment failures than the transient CVF group. In the persistent CVF group, at day 3, a bacterial superinfection was more frequently detected. The 90-day mortality was significantly higher in the persistent CVF group (62%). The 28-day mortality rates for patients without CVF, with transient and with persistent CVF were 19, 35 and 41% respectively and ICU mortality was 60, 38 and 19% respectively. In the multivariate analysis chronic pulmonary conditions, lack of Pa0<sub<2</sub</FiO<sub<2</sub< improvement at day 3, pulmonary superinfection at day 3 and persistent CVF were independently associated with 90-day mortality in ICUAP patients. <i<Conclusions</i<: Persistent CVF has a significant impact on the outcome of patients with ICUAP. Patients at risk from persistent CVF should be promptly recognized to optimize treatment and outcomes.
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title_short	Impact of Cardiovascular Failure in Intensive Care Unit-Acquired Pneumonia: A Single-Center, Prospective Study
url	https://doi.org/10.3390/antibiotics10070798 https://doaj.org/article/58af9d5e552c46f3815ae4c53eb1ac48 https://www.mdpi.com/2079-6382/10/7/798 https://doaj.org/toc/2079-6382
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author2	Adrian Ceccato Marco Carbonara Gianluigi li Bassi Pierluigi di Natale Stefano Nogas Otavio Ranzani Carla Speziale Tarek Senussi Francesco Idone Anna Motos Miquel Ferrer Antoni Torres
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up_date	2024-07-03T18:55:27.691Z
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