Surveillance of ventilator-associated events in intensive care units
Keywords:
ventilator-associated pneumonia, infection control, healthcare associated infectionsAbstract
Introduction: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in adult intensive care units (ICU) worldwide. Diagnosis using conventional criteria (clinical, imaging, microbiological) can generate significant interobserver variability. In order to have a tool for monitoring VAP based on objective variables, in 2013 the United States Centers for Disease Control and Prevention (CDC) established the ventilator-associated event (VAE). However, the application of the method still shows controversial results to date.
Objectives: To describe the results of the implementation of VAE surveillance and to assess the correlation with traditional VAP surveillance, according to conventional criteria, in adult ICU in Cuba.
Method: National multicenter prospective cohort study. Sample: 150 patients admitted to 12 adult ICUs, who required invasive mechanical artificial ventilation for more than 48 hours. Surveillance was performed according to conventional and VAE criteria.
Results: Of a total of 37 patients reported with VAP by conventional criteria, 28 of them (75.7%) agreed with VAP likely according to CDC (Kappa: 0.756, p ˂ 0.001). Patients with possible VAP criteria (CDC) had significantly higher mortality (68.8%, p=0.04).
Conclusions: Surveillance of VAE is an objective method for the early detection of VAP that can also contribute to the homogenization of hospital epidemiological reports.
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