The incidence of nosocomial pneumonia following urgent endotracheal intubation.

The risk of nosocomial pneumonia following emergency or urgent endotracheal intubation was studied prospectively. Pneumonia developed in 35 of 78 (45%) patients within three days of intubation. No differences in age, sex, underlying illness, respiratory infection, or antibiotic use were found between those with or without pneumonia. There were also no differences in the frequency of complications occurring during intubation. Patients developing pneumonia tended to have the same organisms isolated from the sputum at the time of intubation and at the time of diagnosis of pneumonia (9 of 20 were identical, 5 differed by a single organism). Sputum cultures taken at the time of intubation were helpful in predicting the subsequent pathogens in patients who developed pneumonia. There were no differences in mortality between patients with (29%) and without (28%) pneumonia. Emergency endotracheal intubation appears to contribute to the overall incidence of nosocomial pneumonia.