1046 Positive Airway Pressure Therapy and Pneumonia: An Investigative Case Series Through Systematic Data Review

Abstract Introduction Positive airway pressure (PAP) therapy is the primary treatment for sleep apnea. While effective, concerns have been raised regarding a potential association between PAP therapy and pneumonia. Understanding this association is crucial for optimizing patient care and ensuring safety. Methods We conducted a systematic literature review to evaluate the association between PAP therapy and pneumonia. A comprehensive search was performed in databases such as MEDLINE, EMBASE, and the Cochrane library, following PRISMA guidelines. Inclusion criteria encompassed case reports and case series reporting PAP usage before pneumonia diagnosis, while exclusions included cases with pneumonia predating PAP usage. Data extraction and quality assessment were conducted independently. Results The search yielded 32 relevant articles for review. Legionella pneumophila emerged as the most common infecting organism, with instances of inadequate device cleaning associated with pneumonia development. Severity varied among cases, with Legionella cases often requiring intensive care and mechanical ventilation. Mechanisms potentially contributing to pneumonia risk with PAP therapy included aerosolization of pathogens, mucosal irritation, aspiration risk, and device contamination. Conclusion Our systematic review emphasizes the significance of ensuring proper infection management and device hygiene among PAP therapy recipients. However, there is a clear need for further research to clarify the underlying mechanisms to fully understand the association between PAP therapy and pneumonia. Support (if any)