Obesity exerts no influence on ventilator-associated pneumonia risk

Obesity appears to have no significant association with the incidence of ventilator-associated pneumonia (VAP), a study has found.

Researchers conducted a posthoc analysis of the NUTRIREA-2 open-label trial, which was performed in 44 French intensive care units (ICUs). The population comprised 2,325 adults receiving invasive mechanical ventilation and vasopressor support for shock, in addition to parenteral or enteral nutrition.

Of the patients, 699 (30 percent) had obesity, defined as a body mass index (BMI) ≥30 kg/m² at ICU admission. There were 224 first VAP episodes, with 60 occurring in the obese group and 164 in the nonobese group. The 28-day VAP incidence rate did not differ between the two groups (8.6 percent vs 10.1 percent, respectively; hazard ratio [HR], 0.85, 95 percent confidence interval [CI], 0.63–1.14; p=0.26).

In an analysis controlling for multiple confounders, obesity still showed no association with the risk of VAP (HR, 0.893, 95 percent CI, 0.66–1.2; p=0.46).

Ninety-day mortality was significantly lower among obese than nonobese patients (39.3 percent vs 44.7 percent; p=0.02), whereas no significant difference was seen in duration of mechanical ventilation and ICU length of stay.

In a subgroup of patients (n=123) with available pepsin and alpha-amylase measurements, the rate of abundant microaspiration of gastric contents or oropharyngeal secretions was comparable between the obese and nonobese groups.