Purulent tracheobronchitis associated with mechanical ventilation

Abstract

Purulent tracheobronchitis associated with mechanical ventilation (PTB-MV) is a lower respiratory tract infection that affects critically ill patients undergoing prolonged mechanical ventilation in intensive care units. Although it is not accompanied by pulmonary parenchymal infiltrates, it can progress to ventilator-associated pneumonia, increasing morbidity and hospital stay duration. The objective of this study was to conduct a systematic literature review on PTB-MV associated with mechanical ventilation, addressing its epidemiology, diagnosis, treatment, and prevention. The PRISMA 2020 methodology was used to guide the search, selection, and analysis of scientific literature published over the last ten years, utilizing electronic databases and MESH and DeCS descriptors. A total of 29 articles were analyzed after applying strict inclusion and exclusion criteria. The results showed that PTB-MV incidence ranges from 10 % to 25 %, with significant heterogeneity in diagnostic criteria, limiting comparability between studies. Additionally, it was identified that this condition can evolve into pneumonia in a considerable percentage of cases. Regarding treatment, controversy remains over the systematic use of antibiotics, emphasizing the need for strategies based on biomarkers and individual risk factors. Preventive measures, such as infection control and proper secretion management, were found to be fundamental. In conclusion, PTB-MV is a clinically relevant condition that requires greater diagnostic standardization and robust evidence to develop more effective management guidelines that reduce its impact on morbidity and mortality in critically ill patients.