Abstract
Ventilator-associated complications (VACs) are those complications that develop during the period of intubation. The most frequent VAC is infection. Ventilator-associated tracheobronchitis (VAT) is one of the ventilator-associated complications occurring in the critically ill patient. This infection represents an intermediate process between lower respiratory tract colonization and ventilator-associated pneumonia. Increased duration of mechanical ventilation has been reported in patients with VAT because of increased sputum production and airway inflammation. Two studies have shown a beneficial effect of antimicrobial treatment in patients with VAT. The optimal duration of antimicrobial treatment in patients with VAT should be further investigated because short courses of antimicrobials might be sufficient. Aerosolized antibiotics also need to be compared to systemic antibiotics in these patients.
Résumé
La ventilation mécanique invasive est largement utilisée en réanimation. La trachéobronchite acquise sous ventilation mécanique (TAVM) est l’une des complications associées à cette procédure. Cette infection est difficile à différencier de la colonisation des voies respiratoires inférieures ou de la pneumonie acquise sous ventilation mécanique. La TAVM est associée à une prolongation de la durée de la ventilation mécanique et du séjour en réanimation en raison de l’augmentation de l’abondance des sécrétions trachéobronchiques. Deux études récentes ont suggéré que l’antibiothérapie pourrait être bénéfique chez les patients présentant cette infection. La durée optimale de l’antibiothérapie reste à déterminer, mais une antibiothérapie de courte durée devrait être appropriée. Des études randomisées devront comparer l’antibiothérapie inhalée à l’antibiothérapie systémique chez les patients présentant une TAVM.
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Martin-Loeches, I., Nseir, S., Valles, J. et al. From ventilator-associated tracheobronchitis to ventilator-associated pneumonia. Réanimation 22, 231–237 (2013). https://doi.org/10.1007/s13546-013-0678-7
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DOI: https://doi.org/10.1007/s13546-013-0678-7