MIAMI — Blood product transfusion was an independent risk factor for ventilator-associated pneumonia in a study of 766 adult trauma patients, said Grant Bochicchio, M.D., at the joint annual meeting of the Surgical Infection Society and Surgical Infection Society-Europe.
In a prospective, observational cohort study, 26 patients developed ventilator-associated pneumonia, and 22 of the 26 (85%) received blood transfusions prior to their VAP diagnoses, noted Dr. Bochicchio, of the R. Adams Cowley Shock Trauma Center in Baltimore.
The patients, who did not have pneumonia on admission to the ICU, were on ventilators for at least 48 hours. Transfusions of any blood product—red blood cells, plasma, and platelets—were independent risk factors for VAP after controlling for gender, injury severity, number of days on the ventilator, and number of days in the ICU prior to developing VAP.
The odds ratio for VAP due to blood transfusion was significantly higher for trauma patients compared with other ICU patients. In trauma patients, the odds ratio for developing VAP was 3.34 for fresh frozen plasma transfusion, 4.19 for platelet transfusion, and 4.41 for red blood cell transfusion, compared with a 1.8 odds ratio for VAP among nontrauma patients in the ICU, Dr. Bochicchio noted.
Patients with VAP spent significantly more days on ventilators compared with non-VAP patients (35 vs. 11) and significantly more days in the ICU (31 vs. 12). There were no significant differences between VAP and non-VAP patients in terms of age or race, and most patients in each group were male.