Incidence, Risk, and Prevention of Ventilator-Associated Pneumonia in Adult Cardiac Surgical Patients: A Systematic Review

Fitch, Zachary W.; Whitman, Glenn

doi:10.1111/jocs.12260

Cited by 25 publications

(29 citation statements)

References 42 publications

(91 reference statements)

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“…65,68 It was observed that in the case-control studies, the most prevalent extrinsic RF was IMV, 40,69,70 followed by previous hospitalization, 35,39 hospitalization time, 71 low McCabe score at admission, 34 gastrostomy or central line-associated bloodstream infection at admission, 34 recent surgery, 34 acute graft rejection, 38 urologic surgery, 35 antacid use, 33 recent exposure to piperacillin-tazobactam, 72 antibiotic use within the last 3 months, 35 prolonged steroid use, 36,39 orotracheal intubation, 70 catheter use ≥7 days, 73 aspiration of secretions, 70 and high Abbreviated Burn Severity Index score. 41 In the SRs, the most commonly mentioned extrinsic RFs were corticosteroid use, [42][43][44] IMV, 42,43,74 blood transfusion, 42,45,74 elective surgery, 43,45 CVC, 43,44 total parenteral nutrition 43,45 and abdominal surgery, 44,45 among others.…”

Section: Extrinsic Rfs For Infectionmentioning

confidence: 99%

Risk factors for health care–associated infection in hospitalized adults: Systematic review and meta-analysis

Acelas

Almeida

Engelman

et al. 2017

American Journal of Infection Control

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Section: Extrinsic Rfs For Infectionmentioning

confidence: 99%

Risk factors for health care–associated infection in hospitalized adults: Systematic review and meta-analysis

Acelas

Almeida

Engelman

et al. 2017

American Journal of Infection Control

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“…However, the incidence of VAP has been defined somewhat differently from study to study; there is currently no consensus on a common numerator or denominator that represents the overall incidence of VAP on a uniform basis. Commonly reported estimates include the percentage of patients on mechanical ventilation who develop VAP (cumulative incidence) and the number of VAP episodes per 1000 ventilator-days and VAP patients per 1000 ventilator-days [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

Incidence, temporal trend and factors associated with ventilator-associated pneumonia in mainland China: a systematic review and meta-analysis

et al. 2017

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BackgroundData to date is far from sufficient to describe the recent epidemiology of ventilator-associated pneumonia (VAP) in mainland China. This study aimed to estimate the overall incidence of VAP, with a special focus on its temporal trend and associated factors.MethodsMeta-analyses of 195 studies published from 2010 to 2015 were conducted, followed by subgroup analyses by methodological quality, pre-defined setting characteristics and attributes of populations.ResultsThe overall cumulative VAP incidence in mainland China was 23.8% (95% confidence interval (CI) 20.6–27.2%), with the results showing high heterogeneity. The pooled incidence densities were 24.14 (95% CI 21.19–27.51) episodes and 22.83 (95% CI 19.88–26.23) patients per 1000 ventilator-days. A decline in the cumulative incidence was observed from 2006 (49.5%, 95% CI 40.0–59.0%) to 2014 (19.6%, 95% CI 10.4–31.0%); differences in the incidence rates were also documented according to Chinese provinces and diagnostic criteria (p < 0.001). Older age (≥60 years), coma, re-intubation, tracheotomy and prolonged ventilation were the factors significantly associated with the occurrence of VAP.ConclusionsThe incidence of VAP remains high in mainland China but has decreased since 2006. The reported rates vary considerably across individual studies, probably due to variations in diagnosis and geographical region. More studies using standard definitions and cut-off points are needed to better clarify the epidemiology of VAP across the country.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2566-7) contains supplementary material, which is available to authorized users.

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“…In recent years, there has been an increasing amount of literature on the risk factors of VAP [16][17][18][19] Moreover, the risk factors have been further confirmed in several meta-analyses. However, some stu dies focused on risk factors of VAP in neonates, while others focused on the incidence rates, risk f actors and outcomes of VAP in special ICUs, which may have excluded some data from integrated intensive care units (IICUs) and general ICUs [5,20].As such, we systematically reviewed the incide nce rates, risk factors and mortality rates of VAP patients in general ICUs or IICUs to provide evi dence for the clinical prevention of VAP.…”

Section: Introductionmentioning

confidence: 94%

Incidence Rates, Risk Factors, and Mortality Rates of Ventilator-Associated Pneumonia: A systematic Review and Meta-analysis

Wang

Jia

et al. 2020

Preprint

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BackgroundVentilator-associated pneumonia (VAP) is the second most common nosocomial infection in Intensive care units (ICUs) and is associated with the significant utilization of health-care resources. However，the incidence rates, risk factors and mortality rates of VAP are controversial.MethodsThe Web of Science, PubMed and Cochrane Library databases through August 2019 were independently searched by two researchers to collect all relevant studies. Data including morbidity, risk factors and mortality rates of VAP were extracted for the systematic review and meta-analysis.ResultsSixteen studies, including 4 case control studies and 12 cohort studies, on VAP were included in our analysis. In the meta-analysis, we found that the VAP rate was 22/1000 ventilator-days (95% CI 18–25%). The data demonstrated that H 2 blocker use (odds ratio (OR) 1.66; 95% CI 1.17-2.36), nasogastric tube placement (OR 2.88; 95% CI 1.03-8.04), enteral feeding (OR 3.02; 95% CI 2.18-4.20), central vascular catheter (CVC) placement (OR 3.84; 95% CI 2.55-5.78) and tracheotomy (OR 9.13; 95% CI 6.53-12.75) were risk factors of VAP. VAP was associated with an increased risk of mortality (OR 1.15; 95% CI 0.96-1.37). Four articles that were not included in the meta-analysis indicated that hyperoxemia, increased intra-abdominal pressure, and genetic polymorphism may be risk factors for VAP. ConclusionsThis study may contribute to the development of improved infection control strategies for high-risk patients. Additional studies are needed in the future to clarify the incidence rates, risk factors and mortality rates of VAP.

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Incidence, Risk, and Prevention of Ventilator-Associated Pneumonia in Adult Cardiac Surgical Patients: A Systematic Review

Abstract: Ventilator-associated pneumonia remains a major cause of morbidity and mortality in postoperative heart surgery patients. We present a systematic review of the literature on the incidence, risk factors, and prevention of this condition in a population at heightened risk.

Cited by 25 publications

References 42 publications

Risk factors for health care–associated infection in hospitalized adults: Systematic review and meta-analysis

Risk factors for health care–associated infection in hospitalized adults: Systematic review and meta-analysis

Incidence, temporal trend and factors associated with ventilator-associated pneumonia in mainland China: a systematic review and meta-analysis

Incidence Rates, Risk Factors, and Mortality Rates of Ventilator-Associated Pneumonia: A systematic Review and Meta-analysis

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