Abstrakt

The safety and efficacy of inhaled antibiotics use among mechanically ventilated patients: A brief review of evidence.

Mohammed Aldhaeefi, Lubna S Binhadhir, Arij S Alshammari, Arub A Alaqil, Lama A Alhumaidan, Hadeel M Alanazi, Tariq Alqahtani, Nour S Aldhaefi, Namareq F Aldardeer, Alaa Aldhaefi, Raney Ward, Dhakrit Rungkitwattanakul

Mechanical Ventilation (MV) is one of many life-supporting machines used in the Intensive Care Unit (ICU) for acutely ill patients. Most reported MV complications are lung injuries and Ventilator-Associated Pneumonia (VAP). VAP is defined as pneumonia developing in a mechanically ventilated patient ≥ 48 h after tracheal intubation. In addition to high mortality rates reported with VAP, patients with VAP are at higher risk of pulmonary complications. Poor lung penetration of some intravenous antibiotics could result in therapy failure. Many randomized clinical trials and retrospective analyses examined the theoretical benefit of using inhaled antibiotics for VAP treatment. The use of inhaled antibiotics has the advantage of providing a higher lung concentration, minimized systemic toxicities, and a lower risk of induction resistance. The objective of our review article is to provide a review of the safety and efficacy of inhaled antibiotics use among manically ventilated patients in the ICU based on the most recently published evidence.

The main purpose of a mechanical ventilator is to allow the patient time to heal. Usually, as soon as a patient can breathe effectively on their own, they are taken off the mechanical ventilator. Normal inspiration generates negative intrapleural pressure, which creates a pressure gradient between the atmosphere and the alveoli, resulting in air inflow. In mechanical ventilation, the pressure gradient results from increased (positive) pressure of the air source.