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Risks Factors and Outcome of Recurrences in Patients With Ventilator-Associated Pneumonias (REVAP)

NCT06066736 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 1569

Last updated 2025-05-14

No results posted yet for this study

Summary

Ventilator-associated pneumonia (VAP) is a frequent and serious complication in the ICU, defined by the development of a lung infection in patients ventilated for more than 48 hours. The incidence rate of this condition exceeds 18 episodes per 1000 days of mechanical ventilation in Europe. This nosocomial infection is associated with the highest mortality, ranging from 24% to 76% depending on the series. Reducing the incidence of VAP remains a challenge for clinicians, as evidenced by the many recent recommendations that have led to "bundles" to prevent the onset of this complication. Despite this, these recommendations do not propose a strategy to prevent the recurrence of PAVM, a frequent entity with a reported incidence of 25-35% and a non-consensual definition that increases antibiotic consumption, duration of mechanical ventilation and length of stay in the ICU .

In fact, these recurrences can be linked to:

* Intrinsic patient risk factors (immunosuppression, severity of disease, major inflammatory response, reason for initial admission),
* Inappropriate initial antibiotic therapy (type, duration and dose administered),
* Characteristics specific to the pathogens encountered (virulence factors or resistance),
* Intercurrent complications during management of the initial pneumonia (ARDS, abscess, pleural empyema).

Given the frequency of these recurrences, and the persistent doubts about the role of terrain and pathogen characteristics in their genesis, it seems appropriate to look at risk factors that could help anticipate these events.

The aim of our study will be to identify the risk factors and mortality associated with the occurrence of a recurrence of VAP in patients hospitalized in the intensive care unit.

An essential first step in this work will be to identify and then use the most consensual definition of recurrence of VAP, encompassing recurrence, persistence and superinfection. We will use the definitions in the protocol for the ASPIC trial, which is currently undergoing enrolment.

The second step is to identify risk factors for recurrence. By identifying these factors, it could be possible to propose a prognostic score that would enable careful monitoring (or modification of antibiotic therapy) of patients most at risk of recurrence. Such a score could then be evaluated in a prospective study.

Conditions

  • Ventilator-associated Pneumonia

Interventions

OTHER

observational

No intervention, observational group

Sponsors & Collaborators

  • Société Française d'Anesthésie et de Réanimation

    lead OTHER

Principal Investigators

  • Adrien Bouglé, MD · Hôpital La Pitié-Salpêtrière

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2023-12-01
Primary Completion
2024-08-31
Completion
2025-02-26

Countries

  • France

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT06066736 on ClinicalTrials.gov