TY - JOUR T1 - Predictors and outcome of early-onset pneumonia after out-of-hospital cardiac arrest JF - Respiratory Care DO - 10.4187/respcare.02307 SP - respcare.02307 AU - Dirk Pabst AU - Sonja Römer AU - Alexander Samol AU - Philipp Kümpers AU - Johannes Waltenberger AU - Pia Lebiedz Y1 - 2013/03/05 UR - http://rc.rcjournal.com/content/early/2013/03/06/respcare.02307.abstract N2 - Introduction: Early onset pneumonia (EOP) after out-of-hospital cardiac arrest (OHCA) is frequently observed. Causative factors are loss of airway protection during cardiac arrest, pulmonary contusion and emergency airway management. We herein assessed the incidence, risk factors and clinical course of EOP and evaluated the impact of an early exchange of prehospitally inserted endotracheal tube (ETT) Methods: In our retrospective analysis, we included 104 consecutive patients admitted to our ICU after OHCA between 2007 and 2012. All patients underwent therapeutic hypothermia. We analyzed clinical course, inflammatory parameters, clinical pulmonary infections score (CPIS), occurrence of EOP, duration of ventilator support, microbiological findings and short term outcome. Results: 46.2% of the patients received an exchange of ETT directly after hospital admission. Neither ETT-exchange nor observed aspiration were associated with elevated either CPI-score or EOP or proof of microbiological agents in respiratory secretion. We found no differences in duration of ventilator support, paO2/FIO2-index, ICU days or outcome. C-reactive protein was significantly higher in patients with aspiration (p= 0.046). Gender, age, smoker status, aspiration, cause for cardiac arrest, first detected heart rhythm and use of supraglottic airways devices were not associated with EOP. Patients with EOP had a longer need for ventilator support (p=0.005), higher tracheotomy rate (p=0.031), longer ICU duration (p=0.005), higher CRP (p<0.0001), higher body temperature (p=0.003), higher CPIS (p<0.0001) and a lower paO2/FIO2 index (p=0.008). Conclusions: Rate of EOP was not significantly influenced by the exchange of preclinically inserted ETT, but was associated with longer need for mechanical ventilation and ICU duration. ER -