The impact of the Centers for Disease Control and Prevention new surveillance definitions of ventilator-associated event on our clinical practice

Abstract

ABSTRACT Objective Surveillance of ventilator-associated pneumonia is subjective, inaccurate, time-consuming, and does not predict outcomes. The Centers for Disease Control and Prevention (CDC) recommended the use of ventilator-associated event (VAE) definitions instead of ventilator-associated pneumonia (VAP) in 2013. Therefore, we evaluated this novel surveillance algorithm by comparing the results of our VAP and VAE methods. Material Methods We evaluated mechanically ventilated adult medical and surgical patients in our 13-bed intensive care unit (ICU). Nine patients diagnosed with VAP in 2018-2019 and 11 patients diagnosed with VAE in 2022-2024 were retrospectively evaluated. The impact of the new definitions on clinical processes such as days on the mechanical ventilator, duration of antibiotic use, ICU stay in determining infectious status was monitored. Results. Statistical analysis revealed that demographic and numeric data were similar in both VAP and VAE diagnosis groups (p<0.5). When the clinical course of the patients was examined, it was found that only two of the nine VAP patients diagnosed according to the 2004 CDC criteria and one of the three probable VAP (PVAP) patients diagnosed according to the new criteria died of pneumonia. Pneumonia was the main reason of mortality in PVAP group. Conclusion The fact that mortality due to pneumonia was higher in those diagnosed with PVAP suggests that the new criteria may screen not only for pneumonia but also for complications that may confound accurate pneumonia diagnosis.

Keywords

• Mechanical ventilation
• Ventilator-asssociated pneumonia,
• Ventilator-associated event

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