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Ventilator-Associated Pneumonia and Frequency of Circuit Changes FREE TO VIEW

Tsung P. Tsai, MD, PhD*; Yen T. Lin, RRT; Yao C. Wang, MD; Jang M. Su, MD; Shih M. Taso, MD
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Chung-Shan Medical University Hospital, Taichung, Taiwan ROC


Chest. 2004;126(4_MeetingAbstracts):898S. doi:10.1378/chest.126.4_MeetingAbstracts.898S-a
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PURPOSE:  Mechanical ventilator circuits are commonly changed at 2 to 7 day intervals. This study is to evaluate the incidence of ventilator-associated pneumonia and compare the results of ventilator circuit-changes between 3-day and 7-day changes in acute care environment.

METHODS:  235 patients were admitted to an adult intensive care unit who required mechanical ventilator for more than 2 days. 128 patients had their ventilator circuit changed at 3-days interval (Group I) during the first 6 months compared to 7-day interval in 107 patients (Group II) during the subsequent 6-month period. Study patients were evaluated as ventilator-associated pneumonia by clinical criteria for the presence of leukocytosis, fever, purulent secretion, evidence of new infiltrate on chest film.

RESULTS:  Ventilator-associated pneumonia was seen in 5 patients (5/235, 2.12%) and pneumonia rate was of 1.53 per 1000 ventilator days in a total of 3269 ventilator days. In 128 patients receiving 3-day circuit-changes (Group I), the pneumonia was seen in 4 patients (4/128, 3.13%). There were 1704 ventilator days and a pneumonia rate of 2.35 per 1000 ventilator days. In 107 patients receiving circuit-changes every 7 days (Group II), the pneumonia was seen in only one patient (1/107, 0.93%) and there were 1565 ventilator days, and a pneumonia rate of 0.64 per 1000 ventilator days. No statistically significant difference was found between the two groups (P=0.376).

CONCLUSION:  There is no significant difference in the incidence of ventilator-associated pneumonia with ventilator circuit-changes at 3-day and 7-day intervals. Ventilator circuits can be safely changed at weekly intervals without any increased incidence of pneumonia.

CLINICAL IMPLICATIONS:  For ventilator-dependent patients, ventilator circuits can be safely changed at a 7-day interval without increasing the incidence of pneumonia.

DISCLOSURE:  T.P. Tsai, None.

Wednesday, October 27, 2004

12:30 PM - 2:00 PM




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