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Patient Transport From Intensive Care Increases the Risk of Developing Ventilator-Associated Pneumonia

Marin H. Kollef; Benjamin Von Harz; Donna Prentice; Steven D. Shapiro; Patricia Silver; Robert St. John; Ellen Trovillion
Author and Funding Information

Affiliations: From the Pulmonary and Critical Care Division, Department of Medicine, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis,  From the Department of Respiratory Therapy, Barnes-Jewish Hospital, St. Louis,  From the Department of Nursing, Barnes-Jewish Hospital, St. Louis,  From the Department of Infection Control, Barnes-Jewish Hospital, St. Louis

Affiliations: From the Pulmonary and Critical Care Division, Department of Medicine, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis,  From the Department of Respiratory Therapy, Barnes-Jewish Hospital, St. Louis,  From the Department of Nursing, Barnes-Jewish Hospital, St. Louis,  From the Department of Infection Control, Barnes-Jewish Hospital, St. Louis

Affiliations: From the Pulmonary and Critical Care Division, Department of Medicine, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis,  From the Department of Respiratory Therapy, Barnes-Jewish Hospital, St. Louis,  From the Department of Nursing, Barnes-Jewish Hospital, St. Louis,  From the Department of Infection Control, Barnes-Jewish Hospital, St. Louis

Affiliations: From the Pulmonary and Critical Care Division, Department of Medicine, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis,  From the Department of Respiratory Therapy, Barnes-Jewish Hospital, St. Louis,  From the Department of Nursing, Barnes-Jewish Hospital, St. Louis,  From the Department of Infection Control, Barnes-Jewish Hospital, St. Louis


1997 by the American College of Chest Physicians


Chest. 1997;112(3):765-773. doi:10.1378/chest.112.3.765
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Published online

Abstract

Study objective: To determine whether patient transport out of the ICU is associated with an increased risk of developing ventilator-associated pneumonia.

Design: Prospective cohort study.

Setting: ICUs of Barnes-Jewish Hospital, a university-affiliated teaching hospital.

Patients: Five hundred twenty-one ICU patients requiring mechanical ventilation for >12 h.

Intervention: Prospective patient surveillance and data collection.

Measurements and results: The primary outcome measure was the development of ventilator-associated pneumonia. A total of 273 (52.4%) mechanically ventilated patients required at least one transport out of the ICU while 248 (47.6%) patients did not undergo transport. Sixty-six (24.2%) of the transported patients developed ventilator-associated pneumonia compared with 11 (4.4%) patients in the group not undergoing transport (relative risk=5.5; 95% confidence interval [CI]=2.9 to 10.1; p<0.001). Multiple logistic regression analysis demonstrated that a preceding episode of transport out of the ICU was independently associated with the development of ventilator-associated pneumonia (adjusted odds ratio=3.8; 95% CI=2.6 to 5.5; p<0.001). Other variables independently associated with the development of ventilator-associated pneumonia included reintubation, presence of a tracheostomy, administration of aerosols, and male gender.

Conclusions: We conclude that patient transport out of the ICU is associated with an increased risk for the development of ventilator-associated pneumonia.


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