Investigació Aplicada en Malalties Respiratòries

IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer

Ventilator-Associated Pneumonia (VAP)

Objectives

To study the etiology and pathogenesis, diagnosis, prevention and treatment of Ventilator-Associated Pneumonia (VAP)
To identify biomarkers for diagnosis and outcome of VAP
To study the formation of biofilm in intubated and mechanically ventilated patients

Projects in Progress

Microbiological and electron microscope study of biofilm in endotracheal tubes
Efficacy of corticosteroids in patients with VAP
Role of interleukins in diagnosis and outcome of VAP
Pneumonia in the intensive care unit (ICU), associated and not associated with mechanical ventilation

Milestones Achieved

The half-sitting position in bed in ventilated patients reduces the incidence of VAP
Procalcitonin (PCT) is an effective marker for confirming diagnosis of VAP
Automatic control of tracheal tube pressure does not affect the incidence of VAP

Future Challenges

Identification of new VAP biomarkers
Evaluation of new VAP therapies
Evaluation of measures to prevent the formation of biofilm in endotracheal tubes
Clinical monitoring of patients with VAP in order to adapt empirical treatment to the changes in the etiologic agents

Publications

Sequential measurements of procalcitonin in diagnosing ventilator-associated pneumonia
Ramirez P, Garcia MA, Ferrer M, Aznar J, Valencia M, Sauquillo JM, Menendez R, Asenjo MA, Torres A.
Eur Respir J 2008;31:356-362
Automatic control of tracheal tube cuff pressure in ventilated patients in semirecumbent position. A randomized trial
Valencia M, Ferrer M, Farre R, Navajas D, Badia JR, Nicolas JM, Torres A
Crit Care Med 2007: 35: 1543-1549. (text a continuació en idiomes!)
Supine body position is a risk factor of nosocomial pneumonia in mechanically ventilated patients. A randomised clinical trial
Drakulovic MB, Torres A, Bauer TT, Nicolás JM, Nogué S, Ferrer M
The Lancet 1999; 354: 1851-1858
Predictors of prolonged weaning and survival during ventilator weaning in a respiratory ICU
Sellares J, Ferrer M, Cano E, Loureiro H, Valencia M, Torres A
Intensive Care Med. 2011 Mar 4. [Epub ahead of print]
Nosocomial pneumonia in the intensive care unit acquired by mechanically ventilated versus nonventilated patients
Esperatti M, Ferrer M, Theessen A, Liapikou A, Valencia M, Saucedo LM, Zavala E, Welte T, Torres A
Am J Respir Crit Care Med. 2010 Dec 15;182(12):1533-9.
Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: randomised controlled trial
Ferrer M, Sellarés J, Valencia M, Carrillo A, Gonzalez G, Badia JR, Nicolas JM, Torres A
Lancet. 2009 Sep 26;374(9695):1082-8.
Respiratory impedance during weaning from mechanical ventilation in a mixed population of critically ill patients.
Sellares J, Acerbi I, Loureiro H, Dellaca RL, Ferrer M, Torres A, Navajas D, Farre R.
Br J Anaesth. 2009 Dec;103(6):828-32. Epub 2009 Nov 3.
Validation of the American Thoracic Society–Infectious Diseases Society of America Guidelines for Hospital-Acquired Pneumonia in the Intensive Care Unit.
Ferrer M, Liapikou A, Valencia M, Esperatti M, Theessen A, Martinez JA, Mensa J, Torres A.
Clin Infect Dis 2010; 50: 945–952.
Efficacy of linezolid compared to vancomycin in an experimental model of pneumonia induced by methicillin-resistant Staphylococcus aureus in ventilated pigs
Martinez-Olondris P, Rigol M, Soy D, Guerrero L, Agusti C, Quera MA, Li Bassi G, Esperatti M, Luque N, Liapikou M, Filella X, Marco F, de la Bellacasa JP, Torres A.
Crit Care Med. 2011 Sep 15.
Treatment guidelines and outcomes of hospital-acquired and ventilator-associated pneumonia
Torres A, Ferrer M, Badia JR.
Clin Infect Dis. 2010 Aug 1;51 Suppl 1:S48-53
Update in community-acquired and nosocomial pneumonia 2009
Torres A, Rello J
Am J Respir Crit Care Med. 2010 Apr 15;181(8):782-7.

Investigació Aplicada en Malalties Respiratòries

Ventilator-Associated Pneumonia (VAP)

Objectives

Projects in Progress

Milestones Achieved

Future Challenges

Publications

Sequential measurements of procalcitonin in diagnosing ventilator-associated pneumonia

Automatic control of tracheal tube cuff pressure in ventilated patients in semirecumbent position. A randomized trial

Supine body position is a risk factor of nosocomial pneumonia in mechanically ventilated patients. A randomised clinical trial

Predictors of prolonged weaning and survival during ventilator weaning in a respiratory ICU

Nosocomial pneumonia in the intensive care unit acquired by mechanically ventilated versus nonventilated patients

Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: randomised controlled trial

Respiratory impedance during weaning from mechanical ventilation in a mixed population of critically ill patients.

Validation of the American Thoracic Society–Infectious Diseases Society of America Guidelines for Hospital-Acquired Pneumonia in the Intensive Care Unit.

Efficacy of linezolid compared to vancomycin in an experimental model of pneumonia induced by methicillin-resistant Staphylococcus aureus in ventilated pigs

Treatment guidelines and outcomes of hospital-acquired and ventilator-associated pneumonia

Update in community-acquired and nosocomial pneumonia 2009

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