Obesity does not impact incidence of ventilator-associated p
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Obesity does not appear to be associated with an increased incidence of ventilator-associated pneumonia among adults receiving invasive mechanical ventilation and vasopressor support, according to results published in Chest.

Researchers performed a post hoc analysis of 2,325 adults from NUTRIREA2, an open-label, randomized controlled trial, who received invasive mechanical ventilation and vasopressor support for shock and parenteral or enteral nutrition in 44 French ICUs. Obesity was defined as a BMI of at least 30 kg/m2 at ICU admission. Only first ventilator-associated pneumonia episodes were obtained.

The primary outcome was incidence of ventilator-associated pneumonia. Secondary outcomes included incidence of early-onset ventilator-associated pneumonia, duration of mechanical ventilation, ICU length of stay, 90-day mortality rates and incidence of abundant microaspiration of gastric contents or oropharyngeal secretions.

In the cohort, 699 patients (30%; mean age, 67.8 years; 63.7% men) had obesity.

There were 224 first ventilator-associated pneumonia episodes, with 60 episodes occurring in those with obesity and 164 occurring in those with normal weight. At 28 days, the incidence of ventilator-associated pneumonia was 8.6% among patients with obesity and 10.1% among those with normal weight. The incidence of ventilator-associated pneumonia remained nonsignificant between both groups after adjustment for variables.

Researchers observed no significant difference in duration of mechanical ventilation and length of ICU stay between the groups. Ninety-day mortality was lower among patients with obesity compared with those with normal weight (39.3% vs. 44.7%).

In addition, there was no significant difference in the rate of abundant microaspiration of gastric contents or oropharyngeal secretions in a subgroup of 123 patients with pepsin and alpha-amylase measurements.

“These results suggest that obesity is not associated with increased risk for ventilator-associated pneumonia,” the researchers wrote.

Source: https://journal.chestnet.org/article/S0012-3692(21)00255-5/fulltext
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