Russian multicenter observational clinical study “Register of respiratory therapy for patients with stroke (RETAS)”: infectious complications of mechanical ventilation

Background. Stroke is characterized by high prevalence and mortality. Ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT) are the most common pulmonary infectious complications of stroke. Objective. To analyze the prevalence and impact of VAT/VAP on the course and outcomes of stroke. Material and methods. A multiple-center observational clinical study “Register of respiratory therapy in patients with stroke (RETAS)” was conducted under the auspices of the Russian Federation of Anesthesiologists and Reanimatologists. The study involved 14 centers and 1289 patients with stroke undergoing respiratory support. Results. Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa were the most common causative agents of VAP in stroke. VAT increased time of ventilation and weaning from ventilator (p<0.001 and p=0.003, respectively), length of ICU-stay (p<0.001) and reduced the likelihood of favorable outcomes (GOS score 4/5, p=0.048). VAP significantly prolonged mechanical ventilation and ICU-stay (p<0.001). It was associated with higher mortality in the entire cohort of stroke patients (p<0.001). Conclusions. VAT and VAP prolonged mechanical ventilation and time to weaning from ventilator, ICU-stay, as well as deteriorated functional outcomes of stroke.