Prospective Analysis of Incidence of Ventilator-associated Pneumonia Associated with Active and Passive Humidification in SARS-CoV-2 Patients

• Published in: Indian journal of respiratory care 2023-06, Vol.12 (2), p.201-205
• Main Authors: Godavarthy, Purushotham, Mahale, Nilesh, Bahikar, Priyanka, Jagadale, Mrunalini, Choudhary, Divya
• Format: Article
• Language: English
• Subjects: active humidification; passive humidification; ventilator-associated pneumonia
• ISSN: 2277-9019; 2321-4899
• DOI: 10.5005/jp-journals-11010-1049

Aim: Comparison of the incidence of ventilator-associated pneumonia (VAP) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients requiring mechanical ventilation using active and passive humidification. Materials and methods: The prospective study was carried out by the Department of Critical Care Medicine in a tertiary care hospital. Subjects were divided into two groups. Baseline demographic data was collected for both groups. In both the groups, the clinical pulmonary infection score (CPIS), which included—temperature, white blood cell (WBC) count, tracheal aspirate quantity, alveolar oxygen pressure (PaO2)/fraction of inspired oxygen (FiO2) ratio, chest ray, and any pathogenic bacterial growth from tracheal aspirate, was documented, and the final score was analyzed, which predicted the incidence of VAP. The secondary outcomes studied were the independent variables, such as duration of ventilator support, mortality rate, and endotracheal tube (ETT) patency in both groups. Results: The intergroup distribution of primary outcome, including the distribution of CPIS parameters, did not differ significantly in both groups; that is, the VAP rate remained the same in both groups. Secondary outcomes, including duration of ventilator support and mortality rate, remained the same, whereas airway occlusion and peak pressure were higher in the patients receiving passive humidification. Conclusion: The incidence of VAP remained the same in both groups with the use of either active or passive humidification systems. Extended use of both systems resulted in the curtailment of ETT patency, whereas the use of a heated humidifier (HH) lowered the risk for artificial airway occlusion.