ArticleCritical care (London, England)2016
Early pneumonia and timing of antibiotic therapy in patients after nontraumatic out-of-hospital cardiac arrest.
Article in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 44 citations in OpenAlex.
- Demographics and Clinical Features of Postresuscitation Comorbidities in Long-Term Survivors of Out-of-Hospital Cardiac Arrest: A National Follow-Up Study.BioMed research international · 2017Trial
- Optimizing infection management after cardiac arrest: addressing diagnostic uncertainty and therapeutic dilemmas-a narrative review.Journal of intensive care · 2026Review
- Incidence and Risk Factors of Ventilator-Associated Pneumonia in Cardiac Arrest in Patients With Selective Digestive Decontamination.Critical care research and practice · 2025Article
- Monocyte programmed death-ligand 1 upregulation in early post-out-of-hospital cardiac arrest is associated with increased risk of acute respiratory distress syndrome.Resuscitation plus · 2024Article
- Microbiological Profiles after Out-of-Hospital Cardiac Arrest: Exploring the Relationship between Infection, Inflammation, and the Potential Effects of Mechanical Circulatory Support.Journal of clinical medicine · 2024Article
- Review
- Association of multiple rib fractures with the frequency of pneumonia in the post-resuscitation period.Resuscitation plus · 2022Article
- Hypothermia and its role in patients with ST-segment-elevation myocardial infarction and cardiac arrest.Frontiers in cardiovascular medicine · 2022Article
- Salivary Alpha Amylase Bronchial Measure for Early Aspiration Pneumonia Diagnosis in Patients Treated With Therapeutic Hypothermia After Out-of-hospital Cardiac Arrest.Frontiers in medicine · 2022Article
- The prevalence of bacteremia in out of hospital cardiac arrest patients presenting to the emergency department of a tertiary care hospital.Annals of medicine · 2021Article
- Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest Patients.Journal of clinical medicine · 2021Article
- Early Bronchoscopy Improves Extubation Rates after Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Analysis.Journal of clinical medicine · 2021Article
- Article
- Infections in out-of-hospital and in-hospital post-cardiac arrest patients.Internal and emergency medicine · 2020Observational
- State-of-the-art considerations in post-arrest care.Journal of the American College of Emergency Physicians open · 2020Review
- Demographics of Pediatric OHCA Survivors With Postdischarge Diseases: A National Population-Based Follow-Up Study.Frontiers in pediatrics · 2019Article
- Early Changes in Circulatory T Helper Type 1, 2, and 17 Cells of Patients with Out-of-Hospital Cardiac Arrest after Successful Cardiopulmonary Resuscitation.Chinese medical journal · 2018Article
- Endotoxemia induces lung-brain coupling and multi-organ injury following cerebral ischemia-reperfusion.Experimental neurology · 2017Article
- Early antibiotics administration during targeted temperature management after out-of-hospital cardiac arrest: a nationwide database study.BMC anesthesiology · 2016Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile early pneumonia is common in patients after out-of-hospital cardiac arrest (OHCA), little is known about the impact of pneumonia and the optimal timing of antibiotic therapy after OHCA.
methodsWe conducted a 5-year retrospective cohort study, including patients who suffered from OHCA and were treated with therapeutic hypothermia. ICU treatment was strictly standardized with defined treatment goals and procedures. Medical records, chest radiographic images and microbiological findings were reviewed.
resultsWithin the study period, 442 patients were admitted to our medical ICU after successfully resuscitated cardiac arrest. Of those, 174 patients fulfilled all inclusion and no exclusion criteria and were included into final analysis. Pneumonia within the first week could be confirmed in 39 patients (22.4%) and was confirmed or probable in 100 patients (57.5%), without a difference between survivors and non-survivors (37.8% vs. 23.1% confirmed pneumonia, p = 0.125). In patients with confirmed pneumonia a tracheotomy was performed more frequently (28.2 vs. 12.6%, p = 0.026) compared to patients without confirmed pneumonia. Importantly, patients with confirmed pneumonia had a longer ICU- (14.0 [8.5-20.0] vs. 8.0 [5.0-14.0] days, p < 0.001) and hospital stay (23.0 [11.5-29.0] vs. 15.0 [6.5-25.0] days, p = 0.016). A positive end expiratory pressure (PEEP) > =10.5 mbar on day 1 of the hospital stay was identified as early predictor of confirmed pneumonia (odds ratio 2.898, p = 0.006). No other reliable predictor could be identified. Median time to antibiotic therapy was 8.7 [5.4-22.8] hours, without a difference between patients with or without confirmed pneumonia (p = 0.381) and without a difference between survivors and non-survivors (p = 0.264). Patients receiving antibiotics within 12 hours after admission had a shorter ICU- (8.0 [4.0-14.0] vs. 10.5 [6.0-16.0] vs. 13.5 [8.0-20.0] days, p = 0.004) and hospital-stay (14.0 [6.0-25.0] vs. 16.5 [11.0-27.0] vs. 21.0 [17.0-28.0] days, p = 0.007) compared to patients receiving antibiotics after 12 to 36 or more than 36 hours, respectively.
conclusionsEarly pneumonia may extend length of ICU- and hospital-stay after OHCA and its occurrence is difficult to predict. A delayed initiation of antibiotic therapy in OHCA patients may increase the duration of the ICU- and hospital-stay.
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