University of Oulu

Jansson, M., Ala-Kokko, T., Ahvenjärvi, L., Karhu, J., Ohtonen, P., & Syrjälä, H. (2017). What Is the Applicability of a Novel Surveillance Concept of Ventilator-Associated Events? Infection Control & Hospital Epidemiology, 38(8), 983–988. https://doi.org/10.1017/ice.2017.106

What Is the applicability of a novel surveillance concept of ventilator-associated events?

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Author: Jansson, Miia1,2; Ala-Kokko, Tero1,2; Ahvenjärvi, Lauri3;
Organizations: 1Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
2Medical Research Center Oulu, Oulu, Finland
3Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
4Division of Operative Care, Oulu University Hospital, Oulu, Finland
5Department of Infection Control, Department of Infection Control, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2019090226291
Language: English
Published: Cambridge University Press, 2017
Publish Date: 2019-09-02
Description:

Abstract

Background: In 2013, the Centers for Disease Control and Prevention released a novel surveillance concept called the “ventilator-associated event,” which focused surveillance on objective measures of complications among patients that underwent invasive ventilations.

Objective: To evaluate the concordance and possible differences in efficacy (ie, disease severity and outcomes) between 2 surveillance paradigms: (1) infection-related ventilator-associated complications (iVAC) and (2) on conventional ventilator-associated pneumonia (VAP).

Design: Prospective, observational, single-center cohort study.

Patients: This study included 85 adult patients that received invasive ventilation for at least 2 consecutive calendar days in a 22-bed, adult, mixed medical-surgical intensive care unit in Finland between October 2014 and June 2015.

Results: Among these patients, 9 (10.1 per 1,000 days of mechanical ventilation) developed iVAC (10.6%) and 20 (22.4 per 1,000 days of mechanical ventilation) developed conventional VAP (23.5%). The iVAC indicators were most often caused by atelectasis and fluid overload. Compared with patients with conventional VAP, patients with iVAC had significantly worse respiratory status but no other differences in disease severity or outcomes.

Conclusions: The incidence of conventional VAP was >2-fold that of iVAC, and the surveillance paradigms for VAP and iVAC capture different patterns of disease. Our results suggest that this novel surveillance concept, although based on objective measures of declining oxygenation, actually identified deteriorations of oxygenation due to noninfectious causes.

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Series: Infection control & hospital epidemiology
ISSN: 0899-823X
ISSN-E: 1559-6834
ISSN-L: 0899-823X
Volume: 38
Issue: 8
Pages: 983 - 988
DOI: 10.1017/ice.2017.106
OADOI: https://oadoi.org/10.1017/ice.2017.106
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Copyright information: © 2017 by The Society for Healthcare Epidemiology of America. All rights reserved. This is the author’s version of the work. It is posted here by permission of the AAAS for personal use, not for redistribution. The definitive version was published in Infection Control & Hospital Epidemiology on Vol. 38:8, DOI: https://doi.org/10.1017/ice.2017.106.