Preemies at High Risk for Ventilator-Associated Pneumonia

A new study finds extremely premature infants who must receive mechanical ventilation to help them breath are at high risk for a type of pneumonia associated with being on a respirator.

Ventilator associated pneumonia (VAP) is common among people who require mechanical assistance to help them breath during a critical illness. People who develop the condition usually have to stay in the hospital and intensive care unit longer and have higher rates of death. Many studies have been done on adults who develop VAP to identify factors that put them at increased risk for the condition and to gauge overall outcomes for those who develop VAP. This study looked specifically at preterm infants to find risk factors for VAP and measure outcomes in this population.

The study was conducted among 229 infants with low birth weights who were admitted to the neonatal intensive care unit at St. Louis Children’s Hospital from October 2000 to July 2001. Among the group, 67 had estimated gestational age of less than 28 weeks, meaning they were born extremely premature. The rest had gestational ages of more than 28 weeks.

Researchers noted the development of VAP among 19 of 67 infants who were put on mechanical ventilation. The rate of VAP for those with the lower birth weights was higher than that for those with the higher birth weights. Having a bloodstream infection raised the risk an infant would develop VAP. VAP was also identified as an independent risk factor for death, particularly among infants who remained in the NICU for more than 30 days.

SOURCE: Pediatrics, 2003;112:1283-1289