Evaluation of the New Centers for Disease Control and Prevention Ventilator-Associated Event Module and Criteria in Critically Ill Children in Greece.
Title | Evaluation of the New Centers for Disease Control and Prevention Ventilator-Associated Event Module and Criteria in Critically Ill Children in Greece. |
Publication Type | Journal Article |
Year of Publication | 2016 |
Authors | Iosifidis, E., Chochliourou E., Violaki A., Chorafa E., Psachna S., Roumpou A., Sdougka M., & Roilides E. |
Journal | Infect Control Hosp Epidemiol |
Volume | 37 |
Issue | 10 |
Pagination | 1162-6 |
Date Published | 2016 10 |
ISSN | 1559-6834 |
Keywords | Adolescent, 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. |
DOI | 10.1017/ice.2016.135 |
Alternate Journal | Infect Control Hosp Epidemiol |
PubMed ID | 27396590 |