The risk factors of Ventilator Associated Pneumonia and relationship with type of tracheostomy

Altınsoy, Savaş; Çatalca, Sibel; Sayın, Murat; Tütüncü, Emin Ediz

doi:10.1016/j.tacc.2020.06.010

Cited by 2 publications

(2 citation statements)

References 37 publications

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“…This result appears consistent with previous findings obtained from a systematic review and meta-analysis conducted by Ding et al [25]. A similar conclusion follows from a retrospective analysis carried out by Altinsoy et al [26], who recorded VAP more frequently in patients who had undergone either a surgical or percutaneous tracheostomy. Some authors have suggested that for critically ill patients requiring prolonged mechanical ventilation, performing a tracheostomy within 10 days of admission can be associated with a shortened duration of mechanical ventilation [27].…”

Section: Discussionsupporting

confidence: 92%

Risk Factors and Protective Factors against Ventilator-Associated Pneumonia—A Single-Center Mixed Prospective and Retrospective Cohort Study

Pawlik

Tomaszek

Mazurek

et al. 2022

JPM

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Introduction: Understanding the factors associated with the development of ventilator-associated pneumonia (VAP) in critically ill patients in the intensive care unit (ICU) will allow for better prevention and control of VAP. The aim of the study was to evaluate the incidence of VAP, as well as to determine risk factors and protective factors against VAP. Design: Mixed prospective and retrospective cohort study. Methods: The cohort involved 371 critically ill patients who received standard interventions to prevent VAP. Additionally, patients in the prospective cohort were provided with continuous automatic pressure control in tapered cuffs of endotracheal or tracheostomy tubes and continuous automatic subglottic secretion suction. Logistic regression was used to assess factors affecting VAP. Results: 52 (14%) patients developed VAP, and the incidence density of VAP per 1000 ventilator days was 9.7. The median days to onset of VAP was 7 [4; 13]. Early and late onset VAP was 6.2% and 7.8%, respectively. According to multivariable logistic regression analysis, tracheotomy (OR = 1.6; CI 95%: 1.1 to 2.31), multidrug-resistant bacteria isolated in the culture of lower respiratory secretions (OR = 2.73; Cl 95%: 1.83 to 4.07) and ICU length of stay >5 days (OR = 3.32; Cl 95%: 1.53 to 7.19) were positively correlated with VAP, while continuous control of cuff pressure and subglottic secretion suction used together were negatively correlated with VAP (OR = 0.61; Cl 95%: 0.43 to 0.87). Conclusions: Tracheotomy, multidrug-resistant bacteria, and ICU length of stay >5 days were independent risk factors of VAP, whereas continuous control of cuff pressure and subglottic secretion suction used together were protective factors against VAP.

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Section: Discussionsupporting

confidence: 92%

Risk Factors and Protective Factors against Ventilator-Associated Pneumonia—A Single-Center Mixed Prospective and Retrospective Cohort Study

Pawlik

Tomaszek

Mazurek

et al. 2022

JPM

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“…One US study reported that treatment expenses were USD 25,000-28,000 higher per patient with VAP 5 , while the mortality rate in connection with VAP was 5%-65%, depending on the patients' condition. 3,4 VAP incidence in intensive care units (ICUs), where most patients use ventilators, has been reported to range from 8%-28% 5,6 , or 13-51/1,000 ventilator days. 7 The Respiratory Care Unit (RCU), Department of Medicine, Siriraj Hospital, provides care for patients with respiratory failure, unstable blood circulation, respiratory infections, air-borne infections, difficulty weaning from ventilators and severe complications from diagnostic procedures and treatment of respiratory illnesses.…”

Section: Introductionmentioning

confidence: 99%

Comparison Study between Using Disposable and Non-Disposable Ventilator Circuits on Ventilator-Associated Pneumonia and Health Care Costs at a Respiratory Care Unit, Siriraj Hospital

Songmuang

Akatat²,

Wattanagulanurak³

et al. 2023

Siriraj Med J

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Objective: This research aimed to compare the incidence of ventilator-associated pneumonia (VAP) and ventilator circuit costs among patients using disposable ventilator circuits and patients using non-disposable ventilator circuits. Materials and Methods: Observational research was performed consisting of the following: A retrospective chart review of a group of patients who used non-disposable circuits (n=193) and a prospective cohort study of a group of patients using disposable circuits (n=166). The sample was purposively selected based on the following inclusion criteria: patients aged 18 years old and over who were admitted to the Respiratory Care Unit, Siriraj Hospital and ventilated >48 h. Results: VAP incidence in the group non-disposable circuits was 10.41/1,000 ventilator days (n=27, 13.8%) and 10.82 /1,000 ventilator days (n=24, 14.4%) in the group disposable circuits (p=0.871). According to the data analysis using the U-control chart, no statistically significant differences were found. The unit cost of the non-disposable circuit was lower than that of the disposable circuit (THB 295.94), while the work unit personnel satisfaction toward working with disposable circuits was at a good level (Mean=3.83) and medium level (Mean=3.12) in non-disposable circuits (p=0.002). Conclusion: The type of ventilator circuits had no effects on VAP rate. The unit cost of non-disposable circuits was lower than that of disposable circuits, while the work unit personnel had a higher satisfaction working with disposable circuits than non-disposable circuits.

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The risk factors of Ventilator Associated Pneumonia and relationship with type of tracheostomy

Cited by 2 publications

References 37 publications

Risk Factors and Protective Factors against Ventilator-Associated Pneumonia—A Single-Center Mixed Prospective and Retrospective Cohort Study

Risk Factors and Protective Factors against Ventilator-Associated Pneumonia—A Single-Center Mixed Prospective and Retrospective Cohort Study

Comparison Study between Using Disposable and Non-Disposable Ventilator Circuits on Ventilator-Associated Pneumonia and Health Care Costs at a Respiratory Care Unit, Siriraj Hospital

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