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Evaluation of the New Centers for Disease Control and Prevention Ventilator-Associated Event Module and Criteria in Critically Ill Children in Greece.

TitleEvaluation of the New Centers for Disease Control and Prevention Ventilator-Associated Event Module and Criteria in Critically Ill Children in Greece.
Publication TypeJournal Article
Year of Publication2016
AuthorsIosifidis, E., Chochliourou E., Violaki A., Chorafa E., Psachna S., Roumpou A., Sdougka M., & Roilides E.
JournalInfect Control Hosp Epidemiol
Volume37
Issue10
Pagination1162-6
Date Published2016 10
ISSN1559-6834
KeywordsAdolescent, Algorithms, Centers for Disease Control and Prevention (U.S.), Child, Child, Preschool, Critical Illness, Female, Greece, Humans, Infant, Intensive Care Units, Pediatric, Male, Pneumonia, Ventilator-Associated, Respiration, Artificial, Severity of Illness Index, Streptonigrin, United States, Ventilator-Induced Lung Injury, Ventilators, Mechanical
Abstract

OBJECTIVE To evaluate the new adult Centers for Disease Control and Prevention (CDC) ventilator-associated event (VAE) module in critically ill children and compare with the traditionally used CDC definition for ventilator-associated pneumonia (VAP). DESIGN Retrospective observational study of mechanically ventilated children in a pediatric intensive care unit in Greece January 1-December 31, 2011. METHODS Assessment of new adult CDC VAE module including 3 definition tiers: ventilator-associated condition (VAC), infection-related VAC, and possible/probable ventilator-associated pneumonia (VAE-VAP); comparison with traditional CDC criteria for clinically defined pneumonia in mechanically ventilated children (PNEU-VAP). We recorded Pediatric Risk of Mortality score at admission (PRISM III), number of ventilator-days, and outcome. RESULTS Among 119 patients with mechanical ventilation (median [range] number of ventilator-days, 7 [1-183]), 19 patients experienced VAC. Criteria for VAE-VAP were fulfilled in 12 of 19 patients with VAC (63%). Children with either VAC or VAE-VAP were on ventilation more days than patients without these conditions (16.5 vs 5 d, P=.0006 and 18 vs 5 d, P<.001, respectively), whereas PRISM-III score was similar between them. Mortality was significant higher in patients with new VAE-VAP definition (50%), but not in patients with VAC (31.6%), than the patients without new VAE-VAP (14%, P=.007) or VAC (15%, P=.1), respectively. No significant association was found between PNEU-VAP and death. Incidences of PNEU-VAP and VAE-VAP were similar, but the agreement was poor. CONCLUSIONS VAE-VAP and PNEU-VAP found similar prevalence in critically ill children but with poor agreement. However, excess of death was significantly associated only with VAE-VAP. Infect Control Hosp Epidemiol 2016:1-5.

DOI10.1017/ice.2016.135
Alternate JournalInfect Control Hosp Epidemiol
PubMed ID27396590

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