Abstract: Poster Presentations |


John D. Dallas, MD*; Marin H. Kollef, MD; Lee Skrupky, PharmD; Scott Micek, PharmD; Nurelign Abebe, MD
Author and Funding Information

Washington University School of Medicine, St. Louis, MO


Chest. 2009;136(4_MeetingAbstracts):113S. doi:10.1378/chest.136.4_MeetingAbstracts.113S
Text Size: A A A
Published online


PURPOSE:  Ventilator-associated tracheobronchits (VAT) has received attention as an intermediary condition between colonization of the upper respiratory tract and ventilator-associated pneumonia (VAP). Antibiotic therapy for VAT has been touted as a method of preventing subsequent VAP. However, little is known about the incidence of VAT or outcomes associated with it. This study aims to calculate the incidence of VAT relative to VAP in a mixed medical and surgical intensive care unit (ICU) population. In addition, etiologic pathogens and clinical outcomes associated with VAT will be determined.

METHODS:  All patients intubated for more than 48 hours in a total of 43 ICU beds will be screened daily for the diagnosis of VAT or VAP. Clinical outcomes of patients identified as having either VAT or VAP will be recorded. Additionally, cases of VAT that progress to VAP will be analyzed. Patients with a tracheostomy will be excluded.

RESULTS:  After 3 months of data collection, 21 cases of VAP and 11 cases of VAT have been identified. Three cases of VAT have progressed to VAP. The overall mortality rate in the group with VAT (36.4%) is greater than the group with VAP (14.3%). However, VAP is associated with a longer length of hospital stay (25.7 versus 20.3 days) and longer length of ICU stay (14.9 versus 12.5 days). The duration of mechanical ventilation is relatively equal between the VAP (11.3 days) and the VAT (11.5 days) groups. Patients with VAT have had a lower Clinical Pulmonary Infection Score than those with VAP (6.5 versus 4.7). Multidrug resistant pathogens have caused 36.4% of VAT cases.

CONCLUSION:  The incidence of VAT in this study is less than that previously reported in the literature. However, the diagnosis of VAT is associated with a high rate of mortality and is freuqently caused by multidrug resistant pathogens.

CLINICAL IMPLICATIONS:  The use of serial endotracheal tube aspirates as a method of screening for VAT may aid in identifying at risk patients sooner and preventing adverse outcomes.

DISCLOSURE:  John Dallas, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543