October 21, 2015
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Simple surveillance identified poor mechanical ventilation outcomes

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Surveillance of ventilator-associated conditions and infection-related, ventilator-associated complications was valuable in identifying poorer outcomes among patients, according to data published in Infection Control & Hospital Epidemiology.

“The data required to determine [ventilator-associated conditions (VAC)] and [infection-related, ventilator associated complications (IVAC)] can be easily obtained and do not rely on microbiological results, making surveillance of VAC and IVAC practical in developing countries,” researchers from China wrote.

Exclusively monitoring ventilator-associated events (VAE) for ventilator-associated pneumonia (VAP) may be problematic, however, as VAP diagnoses require a microbiological examination of at least one specimen.

For the prospective study, researchers monitored VAC, IVAC and suspected or likely VAP among all adults who received mechanical ventilation (MV) at one of 15 ICUs in Sichuan, China, between April and July 2013. The analysis included data on MV duration, length of stay and hospital mortality in patients with VAC vs. those without VAC.

More than 2,300 patients received MV for a combined 8,438 ventilator days, with 27% of them receiving it longer than 2 days, according to the data.

Four percent of VAE were confirmed, translating to 11.1 cases per 1,000 ventilator days. In addition, 16 cases of possible VAP were detected.

Compared with patients without VAC, those with VAC stayed in the ICU 6.2 days longer, received 7.7 more days of MV and had a greater risk for mortality (50% vs. 27.3%).

Thirty-one patients with VAC also developed IVAC and were associated with even longer durations of ICU (19 days vs. 14 days; P <. 05) and MV (17 days vs. 12 days; P <. 05) compared with those who only experienced VAC, although there was no significant difference in mortality.

The researchers noted that although limited laboratory capability may make identification of possible and probable VAP difficult, these findings suggest that surveillance of VAC may be a valuable tool in diagnosing poor MV outcomes.

“Before VAE surveillance can be widely adopted in developing countries, more studies are required to determine the preventability of VAE,” the researchers wrote. – by Jen Byrne

Disclosure: The researchers report no relevant financial disclosures.