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.
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.
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).
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.
For ventilator-dependent patients, ventilator circuits can be safely changed at a 7-day interval without increasing the incidence of pneumonia.
T.P. Tsai, None.