Ventilatory Parameters Associated to Mortality in Patients with Severe Community-Acquired Pneumonia

Abstract

Introduction: Predicting the outcome in patients treated with invasive ventilation for acute respiratory failure is fully challenging.

Objective: To analyze ventilatory monitoring parameters associated with mortality in patients with severe community-acquired pneumonia.

Methods: A case-control study was carried out in severely-ill patients with community-acquired pneumonia and treated with invasive ventilation. The cases were the deceased patients. The quantitative variables were summarized using the median and the interquartile range, while the Mann-Whitney U test was used in the comparison between cases and controls. The presence of mortality risk and its statistical significance were computed by odds ratio (OR) analysis, their confidence intervals, as well as the Mantel and Haenszel chi-squared test, with significance level ɑ = 0.05.

Results: The patients more likely to die were those with peak pressure ≥ 32 cmH₂O (OR = 9.27), plateau pressure ≥ 24 cmH₂O (OR = 24.10), mean pressure ≥ 19 cmH₂O (OR = 10.21), driving pressure ≥ 19 cmH₂O (OR = 10.98), static compliance < 20 ml/cmH₂O (OR = 5.90) and dynamic compliance < 15 ml/cmH₂O (OR = 14.20).

Conclusions: The variables peak pressure, plateau pressure, mean pressure, driving pressure, static compliance and dynamic compliance were concluded to be associated with mortality in patients with severe community-acquired pneumonia.