Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes

Ting Chang Hsieh, Shao Hsuan Hsia, Chang Teng Wu, Tzou Yien Lin, Chih Ching Chang, Kin Sun Wong

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: 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.

Original languageEnglish
Pages (from-to)37-43
Number of pages7
JournalPediatrics and Neonatology
Volume51
Issue number1
DOIs
Publication statusPublished - Feb 2010
Externally publishedYes

Fingerprint

Ventilator-Associated Pneumonia
Mechanical Ventilators
Pediatric Intensive Care Units
Incidence
Pediatrics
Enteral Nutrition
Critical Care
Hospital Mortality
Artificial Respiration
Observational Studies
Ventilation
Length of Stay
Cohort Studies
Research Personnel
Population

Keywords

  • hospital-acquired pneumonia
  • nosocomial pneumonia
  • ventilator circuit
  • ventilator circuit change
  • ventilator-associated pneumonia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes. / Hsieh, Ting Chang; Hsia, Shao Hsuan; Wu, Chang Teng; Lin, Tzou Yien; Chang, Chih Ching; Wong, Kin Sun.

In: Pediatrics and Neonatology, Vol. 51, No. 1, 02.2010, p. 37-43.

Research output: Contribution to journalArticle

Hsieh, Ting Chang ; Hsia, Shao Hsuan ; Wu, Chang Teng ; Lin, Tzou Yien ; Chang, Chih Ching ; Wong, Kin Sun. / Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes. In: Pediatrics and Neonatology. 2010 ; Vol. 51, No. 1. pp. 37-43.
@article{48ab66fe407b407c88f71f77a7c0acb7,
title = "Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes",
abstract = "Background: 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.",
keywords = "hospital-acquired pneumonia, nosocomial pneumonia, ventilator circuit, ventilator circuit change, ventilator-associated pneumonia",
author = "Hsieh, {Ting Chang} and Hsia, {Shao Hsuan} and Wu, {Chang Teng} and Lin, {Tzou Yien} and Chang, {Chih Ching} and Wong, {Kin Sun}",
year = "2010",
month = "2",
doi = "10.1016/S1875-9572(10)60008-3",
language = "English",
volume = "51",
pages = "37--43",
journal = "Pediatrics and Neonatology",
issn = "1875-9572",
publisher = "臺灣兒科醫學會",
number = "1",

}

TY - JOUR

T1 - Frequency of Ventilator-associated Pneumonia With 3-day Versus 7-day Ventilator Circuit Changes

AU - Hsieh, Ting Chang

AU - Hsia, Shao Hsuan

AU - Wu, Chang Teng

AU - Lin, Tzou Yien

AU - Chang, Chih Ching

AU - Wong, Kin Sun

PY - 2010/2

Y1 - 2010/2

N2 - Background: 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.

AB - Background: 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.

KW - hospital-acquired pneumonia

KW - nosocomial pneumonia

KW - ventilator circuit

KW - ventilator circuit change

KW - ventilator-associated pneumonia

UR - http://www.scopus.com/inward/record.url?scp=76849101958&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=76849101958&partnerID=8YFLogxK

U2 - 10.1016/S1875-9572(10)60008-3

DO - 10.1016/S1875-9572(10)60008-3

M3 - Article

C2 - 20225537

AN - SCOPUS:76849101958

VL - 51

SP - 37

EP - 43

JO - Pediatrics and Neonatology

JF - Pediatrics and Neonatology

SN - 1875-9572

IS - 1

ER -