ACEIs and ARBs may Reduce risk of Ventilator-Associated Pneumonia in High-Risk ICU Patients: Study

Results: The study comprised 8,888 patients, with 897 (10.09%) experiencing VAP. The analysis revealed that patients on ACEI or ARB therapy had a lower risk of developing VAP (OR: 0.79, 95% CI: 0.62–0.99, P = 0.047). Subgroup analyses revealed that the protective effect was observed in patients with AKI (OR: 0.70, 95% CI: 0.52–0.94, P = 0.020), renal failure (OR: 0.14, 95% CI: 0.02–0.84, P = 0.032), and diabetes (OR: 0.64, 95% CI: 0.43–0.94, P = 0.024), as well as in those receiving vasopressors (OR: 0.67, 95% CI: 0.49–0.92, P = 0.012), and antibiotics (OR: 0.74, 95% CI: 0.57–0.96, P = 0.021).

No significant difference in VAP development was observed between patients treated with ACEI versus ARB (OR: 0.84, 95% CI: 0.49–1.47, P = 0.547). This study’s findings suggest a substantial association between the use of ACEIs or ARBs and reduced development of VAP, particularly among patients with specific comorbidities and those on vasopressor and antibiotic therapy. This study may educate the ICU team on the potential benefits of ACEIs and ARBs in preventing VAP, emphasizing the importance of considering these medications in the overall treatment plan.

Reference:

Cai, H., Shen, H. & Cao, X. The association between the use of angiotensin-converting enzyme inhibitors /angiotensin receptor blockers and the development of ventilator-associated pneumonia in the intensive care unit: a retrospective cohort study. BMC Pulm Med 24, 578 (2024). https://doi.org/10.1186/s12890-024-03386-y