Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes
Ventilator-associated pneumonia (VAP) is a common clinical problem. Previous studies involving adult patient cohorts have assessed various risk factors associated with VAP, including ventilator circuit changes. The objective of this study was to examine the incidence of and risk factors associated w...
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doaj-d77e2f0621e044f9b542f5ce2850a11a2020-11-24T22:55:54ZengElsevierPediatrics and Neonatology1875-95722010-02-01511374310.1016/S1875-9572(10)60008-3Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit ChangesTing-Chang Hsieh0Shao-Hsuan Hsia1Chang-Teng Wu2Tzou-Yien Lin3Chih-Ching Chang4Kin-Sun Wong5Division of Pediatrics, Far-Eastern Memorial Hospital, Taipei, TaiwanDivision of Pediatric Critical Care and Emergency Medicine, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Pediatric Critical Care and Emergency Medicine, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Pediatric Infectious Diseases, Chang Gung Children's Hospital, Taoyuan, TaiwanDepartment of Respiratory Therapy, Chang Gung Children's Hospital, Taoyuan, TaiwanDivision of Pediatric Pulmonology, Chang Gung Children's Hospital, Taoyuan, TaiwanVentilator-associated pneumonia (VAP) is a common clinical problem. Previous studies involving adult patient cohorts have assessed various risk factors associated with VAP, including ventilator circuit changes. The objective of this study was to examine the incidence of and risk factors associated with VAP, particularly 3-day versus 7-day ventilator circuit changes, in a pediatric intensive care unit (PICU). Methods: This was a cohort observational study. Patients hospitalized in the PICU at Chang Gung Children's Hospital between November 2003 and September 2004 were enrolled. Investigators and critical-care specialists evaluated baseline characteristics, incidence of VAP, and related variables from PICU admission until discharge or death. Results: Of 397 patients initially enrolled, 96 (aged 11–60 months) were available for statistical analysis and were assigned into two groups according to timing of ventilator circuit change: 3-day (n = 46) and 7-day circuit change (n = 50). No statistically significant differences were observed for VAP incidence (13% vs. 16%, p = 0.68) or hospital mortality (22% vs. 36%, p = 0.14) for 3-day versus 7-day circuit change. Incidence of VAP per 1000 ventilation days was 10.75 and 8.41 for 3-day and 7-day circuit change, respectively. Univariate analysis indicated statistical significance for the duration of mechanical ventilation (10.17 ± 16.63 days vs. 18.20 ± 14.99 days, p< 0.001), length of stay in PICU (22.30 ± 20.48 days vs. 37.22 ± 36.79 days, p= 0.0069) and presence of enteral nutrition [7 (15.22%) vs. 23 (46.0%), p = 0.0012]. Conclusion: Weekly circuit change does not contribute to increased rates of VAP in pediatric patients. Long-term studies evaluating risk factors in larger pediatric patient populations are warranted for further conclusive recommendations.http://www.sciencedirect.com/science/article/pii/S1875957210600083hospital-acquired pneumonianosocomial pneumoniaventilator-associated pneumoniaventilator circuitventilator circuit change |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ting-Chang Hsieh Shao-Hsuan Hsia Chang-Teng Wu Tzou-Yien Lin Chih-Ching Chang Kin-Sun Wong |
spellingShingle |
Ting-Chang Hsieh Shao-Hsuan Hsia Chang-Teng Wu Tzou-Yien Lin Chih-Ching Chang Kin-Sun Wong Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes Pediatrics and Neonatology hospital-acquired pneumonia nosocomial pneumonia ventilator-associated pneumonia ventilator circuit ventilator circuit change |
author_facet |
Ting-Chang Hsieh Shao-Hsuan Hsia Chang-Teng Wu Tzou-Yien Lin Chih-Ching Chang Kin-Sun Wong |
author_sort |
Ting-Chang Hsieh |
title |
Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes |
title_short |
Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes |
title_full |
Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes |
title_fullStr |
Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes |
title_full_unstemmed |
Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes |
title_sort |
frequency of ventilator-associated pneumonia with 3-day versus 7-day ventilator circuit changes |
publisher |
Elsevier |
series |
Pediatrics and Neonatology |
issn |
1875-9572 |
publishDate |
2010-02-01 |
description |
Ventilator-associated pneumonia (VAP) is a common clinical problem. Previous studies involving adult patient cohorts have assessed various risk factors associated with VAP, including ventilator circuit changes. The objective of this study was to examine the incidence of and risk factors associated with VAP, particularly 3-day versus 7-day ventilator circuit changes, in a pediatric intensive care unit (PICU).
Methods: This was a cohort observational study. Patients hospitalized in the PICU at Chang Gung Children's Hospital between November 2003 and September 2004 were enrolled. Investigators and critical-care specialists evaluated baseline characteristics, incidence of VAP, and related variables from PICU admission until discharge or death.
Results: Of 397 patients initially enrolled, 96 (aged 11–60 months) were available for statistical analysis and were assigned into two groups according to timing of ventilator circuit change: 3-day (n = 46) and 7-day circuit change (n = 50). No statistically significant differences were observed for VAP incidence (13% vs. 16%, p = 0.68) or hospital mortality (22% vs. 36%, p = 0.14) for 3-day versus 7-day circuit change. Incidence of VAP per 1000 ventilation days was 10.75 and 8.41 for 3-day and 7-day circuit change, respectively. Univariate analysis indicated statistical significance for the duration of mechanical ventilation (10.17 ± 16.63 days vs. 18.20 ± 14.99 days, p< 0.001), length of stay in PICU (22.30 ± 20.48 days vs. 37.22 ± 36.79 days, p= 0.0069) and presence of enteral nutrition [7 (15.22%) vs. 23 (46.0%), p = 0.0012].
Conclusion: Weekly circuit change does not contribute to increased rates of VAP in pediatric patients. Long-term studies evaluating risk factors in larger pediatric patient populations are warranted for further conclusive recommendations. |
topic |
hospital-acquired pneumonia nosocomial pneumonia ventilator-associated pneumonia ventilator circuit ventilator circuit change |
url |
http://www.sciencedirect.com/science/article/pii/S1875957210600083 |
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