Which of the following is a typical complication of prolonged mechanical ventilation in TBI patients?

• A. Pulmonary embolism
• B. Ventilator-associated pneumonia
• C. Renal failure
• D. Hyperglycemia

Answer: (B)

Prolonged mechanical ventilation increases the risk of infection in the lungs, specifically ventilator-associated pneumonia. This condition develops after about 48 hours of intubation when bacteria from the oropharynx or the ventilator circuit colonize the endotracheal tube and surrounding airways, overcoming the body’s defenses. In someone with a traumatic brain injury, several factors amplify this risk: reduced level of consciousness and impaired airway protection allow microaspiration, sedation and paralysis hinder the ability to clear secretions, and the endotracheal tube itself provides a surface for biofilm formation. These elements make ventilator-associated pneumonia a common and typical complication of long-term ventilation in TBI patients.

Other listed issues can occur in ICU patients, but they’re not as closely tied to the duration of mechanical ventilation. For example, clotting and immobility raise the risk of pulmonary embolism, while kidney injury and high blood sugar may accompany critical illness and injury, but they aren’t specifically caused by prolonged ventilation in the same direct way as VAP.