Ventilator-Associated Pneumonia in COPD Patients: Epidemiology, Pathogenesis, Prevention

Abstract

Chronic obstructive pulmonary disease (COPD) promotes the development of ventilator-associated pneumonia (VAP) in critically ill patients. Specific risk factors for VAP in this particular population include prolonged invasive mechanical ventilation, increased tracheobronchial bacterial colonization, and altered local and general host defense mechanisms.

Invasive mechanical ventilation of COPD patients is still a frequent situation in intensive care, despite the increasing use of non invasive ventilation (NIV) during the last two decades. COPD is identified as an independent risk factor for VAP in several epidemiological studies. Higher mortality and durations of mechanical ventilation and ICU stay have been reported in COPD patients who develop VAP.

NIV may be considered as the main preventive strategy for VAP occurrence in COPD patients. Future studies should focus on specific preventive measures in this high risk population.