Articles Vol. 67 No. 3 31/03/2026

VENTILATOR-ASSOCIATED PNEUMONIA AND ASSOCIATION WITH NUTRITIONAL STATUS IN THE INTENSIVE CARE UNIT OF THE VIETNAM NATIONAL HEART INSTITUTE, 2025

Nguyen Thi Hue1,2, Pham Minh Tuan1,2,3,4
1 Bach Mai Hospital
2 Viện Tim mạch, Bệnh viện Bạch Mai
3 Hanoi Medical University
4 Trường Đại học Y Hà Nội
DOI: 10.52163/yhc.v67i3.4596
22 Views
12 Downloads
Keywords
Ventilator-associated pneumonia, nutritional risk, NRS-2002, multidrug-resistant bacteria.
Abstract

Objective: To evaluate the association between nutritional risk assessed by the NRS-2002 score and the incidence of ventilator-associated pneumonia in cardiovascular intensive care unit patients.

Methods: A cross-sectional study with longitudinal follow-up was conducted on 98 mechanically ventilated patients. Nutritional risk was assessed using NRS-2002. Data on ventilator-associated pneumonia incidence, causative bacteria, duration of mechanical ventilation, and mortality were recorded.

Results: The incidence of ventilator-associated pneumonia was 15.3%, with a density of 28.09 cases/1000 ventilator days (95% CI: 15.72-46.33), predominantly late-onset ventilator-associated pneumonia (93.3%). Overall mortality was 46.9%. The main pathogens included A.baumannii (40%), P.aeruginosa (26.7%), K.aerogenes (26.7%), K.pneumoniae (13.3%), S.aureus (16.3%), E.coli (6.7%), and A.berezinae (6.7%). Patients with high nutritional risk (NRS-2002 ≥ 3 points) had a significantly higher ventilator-associated pneumonia rate compared to low-risk patients (29.8% vs 2%, p < 0.05), with a 19-fold increased risk of ventilator-associated pneumonia. Ventilator-associated pneumonia was associated with higher mortality (73.3% vs 42.2%, p = 0.026) and longer mechanical ventilation duration (9.27 days vs 4.75 days, p = 0.01).

Conclusion: Nutritional risk assessed by NRS-2002 is an independent risk factor for ventilator-associated pneumonia in cardiovascular intensive care unit patients. Early nutritional assessment and intervention are essential to reduce this complication.

References
[1]
Ismail R, Zahran E. The effect of nurses training on ventilator-associated pneumonia (VAP) prevention bundle on VAP incidence rate at a critical care unit. Journal of Nursing Education and Practice. 2015 ;5 (12): 42-48. Google Scholar
[2]
Torres A, Niederman M.S et al. International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT). European Respiratory Journal, 2017, 50 (3). Google Scholar
[3]
Kharel S, Bist A et al. Ventilator-associated pneumonia among ICU patients in WHO Southeast Asian region: A systematic review. PloS one, 2021, 16 (3): e0247832. Google Scholar
[4]
Kalanuria A.A, Zai W et al. Ventilator-associated pneumonia in the ICU. Critical care, 2014, 18 (2): 208. Google Scholar
[5]
Singer P, Blaser A.R et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical nutrition, 2019, 38 (1): 48-79. Google Scholar
[6]
Chen Z, Wu H et al. Nutritional risk screening score as an independent predictor of nonventilator hospital-acquired pneumonia: a cohort study of 67,280 patients. BMC Infectious Diseases, 2021, 21 (1): 313. Google Scholar
[7]
Ścisło L, Walewska E et al. Nutritional status disorders and selected risk factors of ventilator-associated pneumonia (VAP) in patients treated in the intensive care ward - A retrospective study. International Journal of Environmental Research and Public Health, 2022, 19 (1): 602. Google Scholar
[8]
Kalil A.C, Metersky M.L et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clinical infectious diseases, 2016, 63 (5): e61-e111. Google Scholar
[9]
Papazian L, Klompas M et al. Ventilator-associated pneumonia in adults: a narrative review. Intensive care medicine, 2020, 46 (5): 888-906. Google Scholar
[10]
Mergulhão P, Pereira J.G et al. Epidemiology and burden of ventilator-associated pneumonia among adult intensive care unit patients: A Portuguese, multicenter, retrospective study (eVAP-PT Study). Antibiotics, 2024, 13 (4): 290. Google Scholar
[11]
Melsen W.G, Rovers M.M et al. Attributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patient data from randomised prevention studies. The Lancet infectious diseases, 2013, 13 (8): 665-671. Google Scholar
[12]
Zhang X, Kang L et al. Association between nutritional status and pneumonia in patients with spontaneous intracerebral hemorrhage. Frontiers in Nutrition, 2025, 12: 1547655. Google Scholar
[13]
Hoang M.H et al. Efficacy of compliance with ventilator-associated pneumonia care bundle: A 24-month longitudinal study at Bach Mai Hospital, Vietnam.SAGE Open Med, 2024, 12: 20503121231223467. doi: 10.1177/20503121231223467. Google Scholar
[14]
Vũ Văn Khâm và cộng sự. Đánh giá mức độ tuân thủ gói dự phòng viêm phổi liên quan đến thở máy tại Trung tâm Gây mê Hồi sức, Bệnh viện Bạch Mai, 2024, 65 (CĐ 9): 31-37. doi: 10.52163/yhc.v65iCD9.1510. Google Scholar