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13 June 2016 : Clinical Research  

Early-Onset Pneumonia in Non-Traumatic Out-of-Hospital Cardiac Arrest Patients with Special Focus on Prehospital Airway Management

Martin ChristABCDEFG, Katharina Isabel von AuenmuellerAB, Scharbanu AmirieEG, Benjamin Michel SaskoDE, Michael BrandCFG, Hans-Joachim TrappeACDEFG

DOI: 10.12659/MSM.896867

Med Sci Monit 2016; 22:2013-2020

Abstract

BACKGROUND: More than half of all non-traumatic out-of-hospital cardiac arrest (OHCA) patients die in the hospital. Early-onset pneumonia (EOP) has been described as one of the most common complications after successful cardiopulmonary resuscitation. However, the expanded use of alternative airway devices (AAD) might influence the incidence of EOP following OHCA.

MATERIAL AND METHODS: We analyzed data from all OHCA patients admitted to our hospital between 1 January 2008 and 31 December 2014. EOP was defined as proof of the presence of a pathogenic microorganism in samples of respiratory secretions within the first 5 days after hospital admission.

RESULTS: There were 252 patients admitted: 155 men (61.5%) and 97 women (38.5%), with a mean age of 69.1±13.8 years. Of these, 164 patients (77.6%) were admitted with an endotracheal tube (ET) and 62 (27.4%) with an AAD. We found that 36 out of a total of 80 respiratory secretion samples (45.0%) contained pathogenic microorganisms, with Staphylococcus aureus as the most common bacteria. Neither bacterial detection (p=0.765) nor survival rates (p=0.538) differed between patients admitted with ET and those with AAD.

CONCLUSIONS: Irrespective of increasing use of AAD, the incidence of EOP remains high.

Keywords: Airway Management - methods, Aged, 80 and over, Cardiopulmonary Resuscitation, Hospitalization, Incidence, Intubation, Intratracheal - methods, Out-of-Hospital Cardiac Arrest - therapy, Pneumonia - therapy, Survival Rate

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750