Investigació Aplicada en Malalties Respiratòries

Research Lines

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

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  • 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!)

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  • 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

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  • 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]

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  • 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.

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  • 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.

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  • 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.

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  • 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.

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  • 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.

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  • 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

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  • 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.

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  • Association between systemic corticosteroids and outcomes of intensive care unit-acquired pneumonia.  

    Ranzani OT, Ferrer M, Esperatti M, Giunta V, Bassi GL, Carvalho CR, Torres A.  

    Crit Care Med. 2012 Sep;40(9):2552-61.

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  • An In Vitro Study to Assess Determinant Features Associated With Fluid Sealing in the Design of Endotracheal Tube Cuffs and Exerted Tracheal Pressures*    

    Li Bassi G, Ranzani OT, Marti JD, Giunta V, Luque N, Isetta V, Ferrer M, Farre R, Pimentel GL, Torres A.

    Crit Care Med. 2013 Feb;41(2):518-526.

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  • Effects of Manual Rib Cage Compressions on Expiratory Flow and Mucus Clearance During Mechanical Ventilation.    

    Martí JD, Bassi GL, Rigol M, Saucedo L, Ranzani OT, Esperatti M, Luque N, Ferrer M, Vilaro J, Kolobow T, Torres A.

    Crit Care Med. 2013 Jan 10.

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  • Linezolid limits burden of methicillin-resistant Staphylococcus aureus in biofilm of tracheal tubes.  

    Fernández-Barat L, Ferrer M, Sierra JM, Soy D, Guerrero L, Vila J, Li Bassi G, Cortadellas N, Martínez-Olondris P, Rigol M, Esperatti M, Luque N, Saucedo LM, Agustí C, Torres A.  

    Crit Care Med. 2012 Aug;40(8):2385-9.

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  • Direct analysis of bacterial viability in endotracheal tube biofilm from a pig model of methicillin-resistant Staphylococcus aureus pneumonia following antimicrobial therapy.  

    Fernández-Barat L, Li Bassi G, Ferrer M, Bosch A, Calvo M, Vila J, Gabarrús A, Martínez-Olondris P, Rigol M, Esperatti M, Luque N, Torres A.  

    FEMS Immunol Med Microbiol. 2012 Jul;65(2):309-17

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  • Effects of duty cycle and positive end-expiratory pressure on mucus clearance during mechanical ventilation*.  

    Li Bassi G, Saucedo L, Marti JD, Rigol M, Esperatti M, Luque N, Ferrer M, Gabarrus A, Fernandez L, Kolobow T, Torres A.  

    Crit Care Med. 2012 Mar;40(3):895-902.

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