The prevalence of suspected ventilator-associated pneumonia in Scottish intensive care units

Robert Hart (Lead / Corresponding author), Scott McNeill, Sarah Maclean, Jamie Hornsby, Sarah Ramsay

    Research output: Contribution to journalArticle

    Abstract

    Ventilator-associated pneumonia is the most common healthcare-associated infection in mechanically ventilated patients. Despite this, accurate diagnosis of ventilator-associated pneumonia is difficult owing to the variety of criteria that exist. In this prospective national audit, we aim to quantify the existence of patients with suspected ventilator-associated pneumonia that would not be detected by our standard healthcare-associated infection screening process. Furthermore, we aim to assess the impact of tracheostomy insertion, subglottic drainage endotracheal tubes and chlorhexidine gel on ventilator-associated pneumonia rate. Of the 227 patients recruited, suspected ventilator-associated pneumonia occurred in 32 of these patients. Using the HELICS definition, 13/32 (40.6%) patients were diagnosed with ventilator-associated pneumonia (H-posVAP). Suspected ventilator-associated pneumonia rate was increased in our tracheostomy population, decreased in the subglottic drainage endotracheal tube group and unchanged in the chlorhexidine group. The diagnosis of ventilator-associated pneumonia remains a contentious issue. The formalisation of the HELICS criteria by the European CDC should allow standardised data collection throughout Europe, which will enable more consistent data collection and meaningful data comparison in the future. Our data add weight to the argument against routine oral chlorhexidine. The use of subglottic drainage endotracheal tubes in preventing ventilator-associated pneumonia is interesting and requires further investigation.

    Original languageEnglish
    Number of pages8
    JournalJournal of the Intensive Care Society
    DOIs
    Publication statusE-pub ahead of print - 12 Jun 2019

    Fingerprint

    Ventilator-Associated Pneumonia
    Intensive Care Units
    Chlorhexidine
    Drainage
    Tracheostomy
    Cross Infection
    Centers for Disease Control and Prevention (U.S.)
    Gels
    Weights and Measures

    Keywords

    • chlorhexidine
    • healthcare-associated infection surveillance
    • subglottic endotracheal tubes
    • tracheostomy
    • Ventilator-associated pneumonia

    Cite this

    Hart, Robert ; McNeill, Scott ; Maclean, Sarah ; Hornsby, Jamie ; Ramsay, Sarah. / The prevalence of suspected ventilator-associated pneumonia in Scottish intensive care units. In: Journal of the Intensive Care Society. 2019.
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    abstract = "Ventilator-associated pneumonia is the most common healthcare-associated infection in mechanically ventilated patients. Despite this, accurate diagnosis of ventilator-associated pneumonia is difficult owing to the variety of criteria that exist. In this prospective national audit, we aim to quantify the existence of patients with suspected ventilator-associated pneumonia that would not be detected by our standard healthcare-associated infection screening process. Furthermore, we aim to assess the impact of tracheostomy insertion, subglottic drainage endotracheal tubes and chlorhexidine gel on ventilator-associated pneumonia rate. Of the 227 patients recruited, suspected ventilator-associated pneumonia occurred in 32 of these patients. Using the HELICS definition, 13/32 (40.6{\%}) patients were diagnosed with ventilator-associated pneumonia (H-posVAP). Suspected ventilator-associated pneumonia rate was increased in our tracheostomy population, decreased in the subglottic drainage endotracheal tube group and unchanged in the chlorhexidine group. The diagnosis of ventilator-associated pneumonia remains a contentious issue. The formalisation of the HELICS criteria by the European CDC should allow standardised data collection throughout Europe, which will enable more consistent data collection and meaningful data comparison in the future. Our data add weight to the argument against routine oral chlorhexidine. The use of subglottic drainage endotracheal tubes in preventing ventilator-associated pneumonia is interesting and requires further investigation.",
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    The prevalence of suspected ventilator-associated pneumonia in Scottish intensive care units. / Hart, Robert (Lead / Corresponding author); McNeill, Scott; Maclean, Sarah; Hornsby, Jamie; Ramsay, Sarah.

    In: Journal of the Intensive Care Society, 12.06.2019.

    Research output: Contribution to journalArticle

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