THE IMPACT OF IMMUNE SYSTEM DYSFUNCTION ON INFECTION INCIDENCE IN TRACHEOSTOMY PATIENTS IN THE ICU: A SCOPING REVIEW

Abstract

Background: Immune dysfunction in ICU patients with tracheostomies significantly contributes to the increased incidence of infections, including ventilator-associated pneumonia (VAP), bloodstream infections, and infections at the tracheostomy site. Although previous studies have addressed this issue, a deeper understanding of how immune dysfunction impacts infection outcomes in this patient population remains limited. This scoping review aims to explore the relationship between immune dysfunction and infection in ICU patients with tracheostomies. Methods: This scoping review was conducted by systematically identifying relevant literature through comprehensive searches in several electronic databases. Inclusion criteria encompassed studies involving ICU patients with tracheostomies that addressed immune dysfunction and infections. Exclusion criteria included studies that did not focus on the primary topic or were not available in full text. Data were systematically extracted with a focus on variables related to immune dysfunction and infections. Data synthesis was performed narratively, with attention to the types of studies (qualitative and quantitative) included. Results: A total of 15 articles were selected for in-depth analysis. The main themes identified included the increased susceptibility to infections influenced by factors such as immunosuppressive treatments, mechanical ventilation, and immune system dysfunction affecting airway protection and wound healing. The studies included both quantitative and qualitative research, providing a holistic understanding of the relationship between immune dysfunction and infection in ICU patients with tracheostomies. Discussion: The findings indicate that immune dysfunction plays a significant role in increasing infection risk in ICU patients with tracheostomies, with various influencing factors. Further research is needed to explore the immunological mechanisms underlying infections in this patient group. This review also identifies that longitudinal and experimental study designs could provide stronger evidence for interventions aimed at preventing infections associated with immune dysfunction in ICU patients with tracheostomies.