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  • ACEIs and ARBs may...

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

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 3 Dec 2024 2:45 PM  |  Updated On 4 Dec 2024 7:07 AM
ACEIs and ARBs may Reduce risk of Ventilator-Associated Pneumonia in High-Risk ICU Patients: Study
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A study published in BMC Pulmonary Medicine suggests that ACEIs and ARBs may Reduce the risk of Ventilator-Associated Pneumonia in High-Risk ICU Patients.

This study was to examine the association between treatment with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and the risk of developing ventilator-associated pneumonia (VAP) among patients receiving mechanical ventilation (MV) in the intensive care unit (ICU).

Utilizing a retrospective cohort approach, the data were extracted from the Medical Information Mart for Intensive Care IV database. VAP diagnoses were ascertained through the international classification of disease codes recorded in the database. Both univariate and multivariable logistic regression analyses were conducted to assess the association between ACEI or ARB use and VAP. Subgroup analyses were performed to evaluate the impact of comorbidities (AKI, renal failure, diabetes, hypertension, and sepsis), simplified acute physiology score II (SAPS II), as well as the use of vasopressors and antibiotics on this association. Odds ratios (ORs) with 95% confidence intervals (CIs) were used as the evaluation metrics.

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

ACEIsARBsReduceriskVentilator-AssociatedPneumoniaHigh-RiskICUPatientsstudyBMC Pulmonary Medicine
Source : BMC Pulmonary Medicine
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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