Clinical Investigation| Volume 365, ISSUE 2, P162-168, February 2023

The impact of inspiratory pressure level on prevention of ventilator-associated pneumonia: A double-blind, randomized clinical trial

  • Taraneh Naghibi
    Correspondence: Taraneh Naghibi MD, FCCM, Department of Anesthesiology and Critical Care Medicine, Mosavi Educational Hospital, Zanjan University of Medical Science, Zanjan, Iran
    Department of Anesthesiology and Critical Care Medicine, Mosavi Educational Hospital, Zanjan University of Medical Science, Zanjan, Iran
    Search for articles by this author
  • Hamideh Karimi
    Department of Anesthesiology and Critical Care Medicine, Mosavi Educational Hospital, Zanjan University of Medical Science, Zanjan, Iran
    Search for articles by this author
Published:October 02, 2022DOI:



      Atelectasis and pneumonia are highly prevalent in patients under mechanical ventilation. Studies indicate that using ventilation with an open lung concept improves recovery, decreases ventilator-related pneumonia, decreases mortality and leads to faster weaning from the ventilator. Therefore, this study investigated the effect of higher airway pressure on ventilator-associated pneumonia.


      This randomized clinical trial was conducted on 120 patients under mechanical ventilation. The patients were divided into two groups based on ventilator pressure: the control group (pressure level 20) and the intervention group (pressure level 30). Demographic data, disease severity, the incidence of ventilator-associated pneumonia, organ damage, days connected to the ventilator, length of hospitalization in ICU, and mortality were compared between the two groups.


      There was no significant difference in demographic data and disease severity between the two groups. The average Clinical Pulmonary Infection Score in the intervention group was significantly lower than the control group (P = 0.02). The intervention group's average Sequential Organ Failure Assessment score was significantly lower than the control group (p = 0.016).


      High-pressure levels can decrease ventilator-associated pneumonia and organ failure. It is recommended that the study be repeated with a larger, more diverse population.

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