Yıl 2024,
Cilt: 8 Sayı: 3, 211 - 217, 31.12.2024
Elif Hakko
,
Tülin Tünel
,
İpek Karaman
,
Melda Özdamar
Kaynakça
- 1. Al-Tawfiq JA, Abdramalnabi R, Taher A, et al. Surveillance of device associated infections in intensive car units at Saudi Arabian Hospital, 2017-2020. J Infect Public Health. 2023 Jun;16(6):917-921. doi: 10.1016/j.jiph.2023.04.007.
- 2. Pouly O, Lecalitel S, Six S, et al. Accuracy of ventilator-associated lower respiratory tract infections. Ann Intensive Care. 2020;10(1):6. https://doi.org/10.1186/s13613-020-0624-6
- 3. Centers for Disease Control and Prevention. Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR. 2004; 53(No. RR-3).
- 4. Klompas M: Complications of mechanical ventilation- The CDC’s new surveillance paradigm. N Engl J Med. 2013:368:1472-1475. doi: 10.1056/NEJMp1300633
- 5. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008; 36:309–32. doi: 10.1016/j.ajic.2008.03.002.
- 6. Dudeck MA, Weiner LM, Allen-Bridson K, et. al. National Healthcare Safety Network (NHSN) Report, Data Summary for 2012, “Device-associated Module”. Am J Infect Control. 41: (2013):1148-66.
- 7. Klompas M, Branson R, Eichenwald EC, et al. Strategies to prevent ventilator‐associated pneumonia in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35:915‐36 doi: 10.1086/677144
- 8. Magill SS, Klompas M, Balk R, et al. Developing a new, national approach to surveillance for ventilator-associated events. Crit Care Med. 2013;41:2467-75.
- 9. Meduri GU. Diagnosis and differential diagnosis of ventilator-associated pneumonia. Clin Chest Med. 1995; 16:61
- 10. Klompas M, Khan Y, Kleinman K, et al. Multicenter Evaluation of a Novel Surveillance Paradigm for Complications of Mechanical Ventilation. PloS One. 2011 Mar 22;6(3):e18062. doi:10.1371 journal.pone.0018062
- 11. Raoof S, Baumann MH. Critical Care Societies Collaborative. An official multi‐society statement: ventilator‐associated events: the new definition. Crit Care Med. 2014;42:228‐9.
- 12. Knaus WA, Draper EA, Wagner DP, et al. "APACHE II: a severity of disease classification system". Crit Care Medicine. 1985;13 (10): 818-829.
- 13. Carlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987; 40:373–383. Doi: 10.1016/0021-9681(87)90171-8
- 14. Rawat N, Yang T, Ali KJ, et al. Two-state collaborative study of a multifaced intervention to decrease ventilator-associated events. Crit Care Med. 2017;45:1208 doi: 10.1097/CCM.0000000000002463
- 15. Bouadma L, Sonneville R, Garrouste-Orgeas M, et al. Ventilator-associated events: prevelance, outcome, and relationship with ventilator-asssociated pneumonia. Crit Care Med. 2015; 43(9:1798-806. https://doi .org/10.1097/CCM.0000000000001091
- 16. Hassan EA, Elsaman SE. Relationship between ventilator bundle compliance and occurence of ventilator-associated events: a prospective cohort study. BMC Nursing. 2022; 21-207-213
- 17. Ramirez-Estrada S, Pena-Lopez Y, Eshwara VK, et al. Ventilator-associated events versus ventilator-associated respiratory infections –moving into new paradigm or merging both concepts, instead?. Ann Transl Med. 2018;6(21):425-425. https://doi.org/10.21037/ATM.2018.10.54
- 18. Melsen WG, Rovers MM, Groenwold RH, et al. Attributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patients data from randomised prevention studies. Lancet Infect Dis. 2013;13(8):665-71. doi: 10.1016/S1473-3099(13)70081-1.
- 19. Ramirez-Estrada S, Pena-Lopez Y, Rello J. The effects of sedatives, neuromuscular blocking agents and opioids on ventilator-associated events. Eur J Anaesthesio. 2020;37(2):67-69 doi:10.1097/EJA 0000000000001132.
- 20. Harris BD, Thomas GA, Greene MH, et al. Ventilator bundle compliance and risk of ventilator-associated events. Infect Control Hosp Epidemiol 2018;39(6):637-643doi 10-1017/ice.2018.30
- 21. Klompas K, Kleinman K, Khan Y, et al. Rapid and reproducible surveillance for ventilator-associated pneumonia. Clin Infect Dis. 2012;54(3):370-377.
- 22. Tejerina E, Esteban A, Fernandez-Segoviano P, et al. Accuracy of clinical definitions of ventilator-associated pneumonia: comparison with autopsy findings. J Crit Care. 2010; 25:62-68. doi: 10.1016/j.jcrc.2009.05.008
- 23. Balthazar AB, Von Nowakonski A, De Capitani EM, et al. Diagnostic investigation of ventilator associated pneumonia using bronchoalveolar lavage: comparative study with a postmortem lung biopsy. Braz J Med Biol Res. 2001;34: 993-1001. doi: 10.1590/s0100-879x2001000800004
- 24. Shenoy ES, Rosenthal ES, Shao YP, et al. Real-time automated detection of ventilator-associated events: avoiding missed detections, misclassifications, and false detections due to human error. Infect Control Hosp Epidemiol. 2018;39:826-833 doi: 10.1017/ice.2018.97. Epub 2018 May 17.
The impact of the Centers for Disease Control and Prevention new surveillance definitions of ventilator-associated event on our clinical practice
Yıl 2024,
Cilt: 8 Sayı: 3, 211 - 217, 31.12.2024
Elif Hakko
,
Tülin Tünel
,
İpek Karaman
,
Melda Özdamar
Öz
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.
Kaynakça
- 1. Al-Tawfiq JA, Abdramalnabi R, Taher A, et al. Surveillance of device associated infections in intensive car units at Saudi Arabian Hospital, 2017-2020. J Infect Public Health. 2023 Jun;16(6):917-921. doi: 10.1016/j.jiph.2023.04.007.
- 2. Pouly O, Lecalitel S, Six S, et al. Accuracy of ventilator-associated lower respiratory tract infections. Ann Intensive Care. 2020;10(1):6. https://doi.org/10.1186/s13613-020-0624-6
- 3. Centers for Disease Control and Prevention. Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR. 2004; 53(No. RR-3).
- 4. Klompas M: Complications of mechanical ventilation- The CDC’s new surveillance paradigm. N Engl J Med. 2013:368:1472-1475. doi: 10.1056/NEJMp1300633
- 5. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008; 36:309–32. doi: 10.1016/j.ajic.2008.03.002.
- 6. Dudeck MA, Weiner LM, Allen-Bridson K, et. al. National Healthcare Safety Network (NHSN) Report, Data Summary for 2012, “Device-associated Module”. Am J Infect Control. 41: (2013):1148-66.
- 7. Klompas M, Branson R, Eichenwald EC, et al. Strategies to prevent ventilator‐associated pneumonia in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35:915‐36 doi: 10.1086/677144
- 8. Magill SS, Klompas M, Balk R, et al. Developing a new, national approach to surveillance for ventilator-associated events. Crit Care Med. 2013;41:2467-75.
- 9. Meduri GU. Diagnosis and differential diagnosis of ventilator-associated pneumonia. Clin Chest Med. 1995; 16:61
- 10. Klompas M, Khan Y, Kleinman K, et al. Multicenter Evaluation of a Novel Surveillance Paradigm for Complications of Mechanical Ventilation. PloS One. 2011 Mar 22;6(3):e18062. doi:10.1371 journal.pone.0018062
- 11. Raoof S, Baumann MH. Critical Care Societies Collaborative. An official multi‐society statement: ventilator‐associated events: the new definition. Crit Care Med. 2014;42:228‐9.
- 12. Knaus WA, Draper EA, Wagner DP, et al. "APACHE II: a severity of disease classification system". Crit Care Medicine. 1985;13 (10): 818-829.
- 13. Carlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987; 40:373–383. Doi: 10.1016/0021-9681(87)90171-8
- 14. Rawat N, Yang T, Ali KJ, et al. Two-state collaborative study of a multifaced intervention to decrease ventilator-associated events. Crit Care Med. 2017;45:1208 doi: 10.1097/CCM.0000000000002463
- 15. Bouadma L, Sonneville R, Garrouste-Orgeas M, et al. Ventilator-associated events: prevelance, outcome, and relationship with ventilator-asssociated pneumonia. Crit Care Med. 2015; 43(9:1798-806. https://doi .org/10.1097/CCM.0000000000001091
- 16. Hassan EA, Elsaman SE. Relationship between ventilator bundle compliance and occurence of ventilator-associated events: a prospective cohort study. BMC Nursing. 2022; 21-207-213
- 17. Ramirez-Estrada S, Pena-Lopez Y, Eshwara VK, et al. Ventilator-associated events versus ventilator-associated respiratory infections –moving into new paradigm or merging both concepts, instead?. Ann Transl Med. 2018;6(21):425-425. https://doi.org/10.21037/ATM.2018.10.54
- 18. Melsen WG, Rovers MM, Groenwold RH, et al. Attributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patients data from randomised prevention studies. Lancet Infect Dis. 2013;13(8):665-71. doi: 10.1016/S1473-3099(13)70081-1.
- 19. Ramirez-Estrada S, Pena-Lopez Y, Rello J. The effects of sedatives, neuromuscular blocking agents and opioids on ventilator-associated events. Eur J Anaesthesio. 2020;37(2):67-69 doi:10.1097/EJA 0000000000001132.
- 20. Harris BD, Thomas GA, Greene MH, et al. Ventilator bundle compliance and risk of ventilator-associated events. Infect Control Hosp Epidemiol 2018;39(6):637-643doi 10-1017/ice.2018.30
- 21. Klompas K, Kleinman K, Khan Y, et al. Rapid and reproducible surveillance for ventilator-associated pneumonia. Clin Infect Dis. 2012;54(3):370-377.
- 22. Tejerina E, Esteban A, Fernandez-Segoviano P, et al. Accuracy of clinical definitions of ventilator-associated pneumonia: comparison with autopsy findings. J Crit Care. 2010; 25:62-68. doi: 10.1016/j.jcrc.2009.05.008
- 23. Balthazar AB, Von Nowakonski A, De Capitani EM, et al. Diagnostic investigation of ventilator associated pneumonia using bronchoalveolar lavage: comparative study with a postmortem lung biopsy. Braz J Med Biol Res. 2001;34: 993-1001. doi: 10.1590/s0100-879x2001000800004
- 24. Shenoy ES, Rosenthal ES, Shao YP, et al. Real-time automated detection of ventilator-associated events: avoiding missed detections, misclassifications, and false detections due to human error. Infect Control Hosp Epidemiol. 2018;39:826-833 doi: 10.1017/ice.2018.97. Epub 2018 May 17.