FAQ - Pneumonia, Ventilator-Associated
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Can a person live if they get pneumonia and are on a ventilator?

My bff got pneumonia and was put on a ventilator because of pulmonary distress she has been on one for 2 weeks now. Today she is not responsive and her heart rate drooped. i keep thinking the wost she is only 25. Are there cases that the person comes out of this alive or is it almost always fatal?


Hi, I have thirty plus years of experience in the field of respiratory care ... from Trauma Medicine to all facets of critical care .... there are so many things you haven't told me ... that I know that you have no info on ... so it makes it difficult to comment on this case ....

That said .. I would think that DIANE .. has said it best ... she is young .. which is always good ... and frequently we heavily sedate patients with severe lung dysfunction for multiple reasons ... generally to keep them from increasing their oxygen needs ...

The best you can do is to be there for her ... and pray that she pulls through ... I know it is scary ... please feel free to contact me if you have any specific questions regarding her ICU care ... I have a ton of people to refer to if I do not have the answer ... hang in there :)  (+ info)

what is the risk factors of ventilator associated pneumonia?

Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that occurs in patients receiving mechanical ventilation for longer than 48 hours. The incidence of VAP is 22.8% in patients receiving mechanical ventilation, and patients receiving ventilatory support account for 86% of the cases of nosocomial pneumonia. Furthermore, the risk for pneumonia increases 3- to 10-fold in patients receiving mechanical ventilation.

Although any patient with an endotracheal tube in place for more than 48 hours is at risk for VAP, certain patients are at higher risk. The risk factors for VAP can be divided into 3 categories: host related, device related, and personnel related. Host-related risk factors include preexisting conditions such as immunosuppression, chronic obstructive lung disease, and acute respiratory distress syndrome. Other host-related factors include patients’ body positioning, level of consciousness, number of intubations, and medications, including sedative agents and antibiotics. In one study, bacterial contamination of endotracheal secretions was higher in patients in the supine position than in patients in the semirecumbent position. Whether due to a pathophysiological process, medication, or injury, decreased level of consciousness resulting in the loss of the cough and gag reflexes contributes to the risk of aspiration and therefore increased risk for VAP. Reintubation and subsequent aspiration can increase the likelihood of VAP 6-fold.

Device-related risk factors include the endotracheal tube, the ventilator circuit, and the presence of a nasogastric or an orogastric tube. Secretions pool above the cuff of an endotracheal tube, and low cuff pressures can lead to microaspiration and/or leakage of bacteria around the cuff into the trachea. As mentioned earlier, nasogastric and orogastric tubes disrupt the gastroesophageal sphincter, leading to reflux and an increased risk for VAP. The question of whether placement of nasogastric or orogastric tubes distal to the pylorus decreases the risk of aspiration and VAP remains unanswered. The results of studies on the relationship between use of small-bore feeding tubes and the incidence of VAP have been inconclusive. The Centers for Disease Control and Prevention makes no recommendations about routine use of postpyloric feeding tubes or small-bore feeding tubes, because these issues remain controversial and further research is needed.

Improper hand washing resulting in the cross-contamination of patients is the biggest personnel-related risk factor for VAP. Patients who are intubated and receiving mechanical ventilation often need interventions such as suctioning or manipulation of the ventilator circuit. These interventions increase the likelihood of cross-contamination between patients if healthcare staff do not use proper hand-washing techniques. Failure to wash hands and change gloves between contaminated patients has been associated with an increased incidence of VAP.  (+ info)

Ventilator-associated Pneumonia (VAP) chances of survive?

My mother is in her 10th day since she was put on breathing machine (in Intensive-care unit), and 7 days ago, she got Ventilator-associated Pneumonia (VAP). Since then, her state is not improving, but also not worsting. Her vital functions are OK, her oxygen saturation is 90%. What are her chances to survive? Pls answer

I know you want a concrete answer, but I can't give you one.
why is she in the ICU? 10 days on a vent is a long time, even with pneumonia.
Does she have a history of smoking or lung or heart problems?

There are a lot of factors to consider, BUT I can say that just because a person gets pneumonia doesn't mean that they are likely to die.
If your mom was relatively healthy, then she has a fighting chance.
If she has a lot of health problems, then she has a mountain to climb, but don't count her out.

You say she isn't improving, but not getting worse either. To me that sounds like you are concerned that she isn't getting off the ventilator? Again, if she has any previous health problems, she may need extra time for her body to recover.
stay strong. good luck  (+ info)

According to the Centers for Disease Contol, how many people die from ventilator-associated pneumonia (VAP) ea

VAP is the leading infectious cause of
death in the ICU, affecting approximately 250,000 people annually and causing
up to 60,000 deaths per year.  (+ info)

How can you get rid of recurring pneumonia?

Last year my mother had both pneumonia and MRSA pneumonia and is currently on a ventilator. We were told the MRSA would always stay in her body. Now an xray has shown she has pneumonia again, but we can't tell which kind without a culture. Is there anything she can do to help prevent pneumonia from constantly coming back?

I get a pneumonia shot every 7 years.
I'm sure your doctor has informed you
of it. It really does work.

God bless you mother.  (+ info)

What should your O2 Saturation be on a ventilator?

My friend is on a ventilator in ICU, sedated with an pneumonia. The nurse said she was critical because her o2 stat was 88 and now 94. Is that a REALLY bad sign because she is on the ventilator? I remember my mom having an o2 of the low 90's but she wasn't on a ventilator and as long as she was above 90 no one worried...Anyone know about o2 stats and ventilators?

You still need to have, ideally, between 95-98% oxygen staturation levels. Anything below 94 can cause problems due to the lack of oxygen, and at 88% you are getting into danger territory for the kidneys and brain. All a ventilator does is make you breath, sometimes deeper than you would voluntarily- and with a ventilator it's possible to deliver 100% oxygen deep into lung tissues. That would be important for your friend, because the oxygen will help dry out the lungs and use whatever capacity she does have to the utmost. The levels would be on the low end because with pneumonia you do not have full lung capacity. So it's important that what there is works at maximum efficiency. In some cases, when lung function itself is not the problem you may see ox sat levels hover in the low 90's due to other problems- like anemia or other disease. Conscious folks generally don't like to cooperate with a ventilator either, and they really don't like having the tube down their throat- so for conscious folks with levels above 90, you don't subject them to it. You deliver oxygen via a nasal canula instead, and encourage them to breathe deep. For your friend though, the ventilator makes sure she has all the oxygen she needs, and the body can concentrate on repairs rather than fighting for breath.  (+ info)

Do you have to have a Trach when on a Ventilator?

A friend of mine is sick with pneumonia. They put her on a ventilator and gave her a trach. Im wondering, do they always do a trach when they put a pneumonia patient on a ventilator?
So most times, a trach is not necessary, but because she is so sick, she had to get it?

Either you friend was a difficult intubation and her airway was too narrow for the endotrachal tube to fit, or she has been on the vent for 2-3 weeks and is unable to be extubated and maintain her airway. No, most times people on the vent come off with in 1 hr to 72hrs. After that their is an increase in Ventilator Associated Pneumonia or VAP, which leads to the need for a trach, which also leads to staph infections, MRSA, etc.......what ever caused her to be intubated in the first place has to be resolved before they take her off the vent.....sorry  (+ info)

Ventilator for pneumonia?

If pneumonia worsens where the patient can't breathe and they put a venilator in, will the patient still be conscious?
Main question is can you be conscious when a ventilator is down the throat? What would it feel like? Thanks

Yes, you can be conscious while on a ventilator. It depends on the situation. Of course there are many conditions which require a person to be on a respirator but let's stick with your scenario of a patient with pneumonia. First of all, if the pneumonia is that bad, the patient might not be conscious anyway. Secondly, they might have to be sedated to put the endotracheal tube into their lungs.
Pneumonia can lead to a blood infection called Sepsis, which will require them to be on life support for a prolonged period of time to give the antibiotics and other medications a chance to work. Otherwise the patient's body would be overwhelmed leading to death.
This is a circumstance in which the doctors might want to put the patient into an induced coma, with medication, to minimize the oxygen consumption and the patient's discomfort. Let's face it, it's not the most pleasant thing to have a tube down your throat and a machine breathing for you. But, if you need it, it's the greatest thing that could happen.
The doctors (usually a Pulmonologist) and Respiratory Therapists monitor the respirator patients very closely to determine when is the best time to wean them off of it. This is what happens when the infection is clearing and the lungs are healing.
I have been on both sides of that scenario. The doctors put me in an induced coma until I got better enough to come off the ventilator and get the endotracheal tube taken out. I had pneumonia and went into Respiratory Failure. Obviously, I got better. I was a Respiratory Therapist for 35 years and saw the science of critical care come from what would be considered primitive, to the advanced degree it is today.
As to how the tube feels in your throat, I didn't notice it all that much except, when I woke up, I explored it with my tongue and it felt odd, mostly but not necessarily uncomfortable. I remember feeling the tape that was holding it in there and wondered at it's layered feeling. Hard to explain. I remembered how it felt before getting to the hospital and was just glad to be able to breathe comfortably again. That suffocating feeling from the pneumonia is the worst.
Anyway, good question. You seem to have the sensitivity needed to be in healthcare, if you're not already in it.  (+ info)

My friend's son has been in ICU with double pneumonia & H1N1. He's been on a ventilator since 12/18.?

He is now on dialysis as well. I've heard the longer a person is on assisted breathing, the less their chances are for full lung recovery. Is this true? Do the lungs become dependent where they will not function on their own again? Patient is a young adult male.

answer to your thoughts is yes and no. first length of time on a ventilator does not dictate full recovery or not, but the longer on a ventilator the more difficult can be the weaning process. many times the patient may be weaned only to need to be placed back on the ventilator with new weaning trials starting again. the lungs do not exactly become dependent but the chest muscles and neuromuscular controls to the diaphragm, and medula do get "weak" causing ventilator challenges. young people with no prior chronic lung disease are more likely to make a full recovery. a great deal depends on the pulmonologist who manages the ventilator, the therapists and their assessment skills, and the nurse/s. all three are trying to function as a medical team but each is protective of their turf and "their" patient. the doctor has the ultimate control regardless of who is the care giver. dialysis is for maintaining metabolic stasis, keeping the blood from building up toxic levels of metablolic waste /acids and such (this is because the kidneys tend to shut down as these metabolites increase in the blood stream). after two weeks often sooner, doctors want to do a tracheotomy to maintain ventilation. you dont mention this but i'd say its coming soon if it hasnt been done yet and he is still on the ventilator. 2 weeks on a ventilator is longer than usual for many situations, but 3, 4, 5 months can also be in the future if things really got ugly. doctors depend a lot on the underlying strength of the patient (body) to fight for its survival. they only provide care to treat apparent symptoms.. so many drugs get pushed into the patient. the body does the healing. doctors want patients off ventilators as soon as possible but not always can they just unhook someone and expect that someone to carry on on their own. this is the time for patience, trust, and faith. there is little you can do medically but remember to constantly encourage the patient. play some soothing music, give them body massages, make sure they get bathed, cleaned, and turned on schedule and even more frequently if possible. not to easy to accomplish but from your end this is good to be able to do for the patient.

i suspect he will come through this. i have been with thousands of ventilator patients, most recover if they werent already debilitated by something else like lung disease, old age, major trauma, weak heart. as long as they can keep him stable, treat the flu issues, and gain ground on the ventilatory weaning process he will get better.  (+ info)

How likely is it that my pneumonia bug is the same as my mother's? (Hers was contracted on a ventilator)?

My mother was on a ventilator for 3 weeks because of respiratory failure due to BOOP (bronchiolitis obliterans organizing pneumonia). While on the ventilator, she also contracted ventilator-associated pneumonia -- and a nasty version at that, one caused by the pseudomonas aeruginosa bacteria. A week and a half ago, she got off the ventilator and is breathing on her own but is still being treated for the pneumonia and is coughing constantly. I've been at her side throughout all this and was just diagnosed with pneumonia myself today although my doctor didn't take a sputum sample so, so far, isn't checking to see exactly what bug is causing my pneumonia. I'm being treated with a general antibiotic (azithromycin) but am concerned that, if it is pseudomonas aeruginosa, I may need to be on the same antibiotics as my mother (and they're treating her with two at once to fight this nasty bacteria which is known to be able to become resistant to many types of antibiotics).

Although possible, it is unlikely. Pseudomonas aeruginosa is primarily a nosocomial pathogen. According to the CDC, the overall incidence of P. aeruginosa infections in U.S. hospitals averages about 0.4 percent (4 per 1000 discharges), and the bacterium is the fourth most commonly-isolated nosocomial pathogen accounting for 10.1 percent of all hospital-acquired infections.

If you are up and walking around, I doubt that you need the antibiotics that your mother is receiving.

Pseudomonas aeruginosa has become increasingly recognized as an emerging opportunistic pathogen of clinical relevance. Several different epidemiological studies track its occurrence as a nosocomial pathogen and indicate that antibiotic resistance is increasing in clinical isolates.

That being said, you havent been isolated to have this organism. There are so many possible causes of your pneumonia that a broad spectrum is most likely in order. I would have liked you to have a sputum sample for culture and sensitivity to enhance the liklihood that the antibiotic is a good choice for the trearment of your condition.

If you start to have worsening symptoms ... go to the ER.

Good luck!  (+ info)

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