scholarly journals Timelines of Oral Care and Early-Onset Ventilator Associated Pneumonia Prevention

2014 ◽  
Author(s):  
Kristen Francoeur
Keyword(s):  
Endotracheal Tube ◽  
Early Onset ◽  
Local Level ◽  
Quality Care ◽  
Oral Care ◽  
Retrospective Chart Review ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Prevention Measures ◽  
Early Application

<p>Hospital-acquired infections, including ventilator associated pneumonia (VAP), are a significant cause of morbidity and mortality and associated with increased costs and length of stay (Chastre & Fagon, 2002; NNIS, 2004). Ventilator associated pneumonia is believed to primarily result from aspiration of oropharyngeal secretions around the endotracheal tube cuff into the lungs (Grap, Munro, Unoki, Hamilton, & Ward, 2012). A randomized control trial tested early application of oral chlorhexidine (CHG) on oral microbial flora and VAP in trauma patients and suggested that early (within 12 hours of intubation) application may reduce VAP rates in trauma patients (Grap, Munro, Hamilton, Elswick, Sessler & Ward, 2011). The VAP rate in a local Level 1 trauma center, 11-bed trauma intensive care unit (TICU) was 8.7 per 1000 device days, above the national average (NHSN, 2011). The purpose of this research was to explore the relationship between the time of insertion of an endotracheal tube and first CHG application and early onset (within 72 hours of intubation) VAP. A retrospective chart review of the records of randomly selected adult intubated trauma patients hospitalized on the TICU was conducted. Collected data included: time of intubation; timing of CHG application; VAP occurrences; and length of intubation. Less than half (45.8%) of patients received early CHG application, and most (79.2%) were intubated in the emergency department (ED), suggesting that VAP prevention measures begin in the ED. Of the patients reviewed, five developed VAP; three occurred in patients who had received oral CHG within 12 hours of intubation. A CNS-driven collaboration with other disciplines and departments is essential to implement VAP prevention measures and provide comprehensive, quality care.</p>

Retrospective Analysis of the Risk Factors and Pathogens Associated With Early-onset Ventilator-associated Pneumonia in Surgical-ICU Head-trauma Patients

2010 ◽  
Vol 22 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Didier Lepelletier ◽  
Antoine Roquilly ◽  
Dominique Demeure dit latte ◽  
Pierre Joachim Mahe ◽  
Olivier Loutrel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Analysis ◽  
Head Trauma ◽  
Early Onset ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Surgical Icu

Effect of oral care in reducing the incidence of early‐onset ventilator‐associated pneumonia in preterm infants

2021 ◽  
Author(s):  
Yoshinori Katayama ◽  
Hiromi Takanishi ◽  
Yumi Sato ◽  
Satoshi Fujita ◽  
Masahiro Enomoto
Keyword(s):  
Preterm Infants ◽  
Early Onset ◽  
Oral Care ◽  
Ventilator Associated Pneumonia

scholarly journals Impact of a Low-Pressure Polyurethane Adult Endotracheal Tube on the Incidence of Ventilator-Associated Pneumonia: A before and after Concurrence Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
John Schweiger ◽  
Rachel Karlnoski ◽  
Devanand Mangar ◽  
Jaya Kolla ◽  
Gerardo Munoz ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
High Volume ◽  
Low Pressure ◽  
Ventilator Associated Pneumonia ◽  
Cuffed Endotracheal Tube ◽  
Number Of Patients ◽  
Before And After ◽  
Control And Prevention

Background. Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care unit (ICU) patients, encompassing up to 15% of all hospital acquired infections. Our hospital implemented a facility-wide conversion from a low-volume high-pressure polyvinyl cuffed endotracheal tube (PV-cuffed ETT) to a high-volume low-pressure (HVLP) polyurethane-cuffed endotracheal tube (PU-cuffed ETT) in an effort to reduce the incidence of VAP. Methods. We completed an IRB approved, retrospective chart review comparing the number of episodes of VAP 12 months preceding and following the introduction of a new ETT. A diagnosis of VAP was made based upon the guidelines of our institution, consistent with the Center of Disease Control and Prevention definition. Results. The number of patients developing VAP the year after the ETT conversion reduced to 32 (16.3%) from 68 (24.7%) the year before the conversion (). The rate of VAP was reduced by 56% per ventilator day after the implementation of the PU-cuffed ETT (). No significant differences were observed in length of hospital stay, length of mechanical ventilation, or mortality before or after the conversion. Conclusions. We found that HVLP PU-cuffed ETTs were associated with a statistically significant reduction of VAP in the adult ICUs.

scholarly journals Resolution of Clinical and Laboratory Abnormalities after Diagnosis of Ventilator-Associated Pneumonia in Trauma Patients

2013 ◽  
Vol 14 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Joseph M. Swanson ◽  
Kathryn A. Connor ◽  
Louis J. Magnotti ◽  
Martin A. Croce ◽  
Jessica Johnson ◽  
...  
Keyword(s):  
Trauma Patients ◽  
Ventilator Associated Pneumonia

scholarly journals Evaluation of Early Onset Sepsis, Complete Blood Count, and Antibiotic Use in Gastroschisis

2017 ◽  
Vol 35 (04) ◽  
pp. 385-389
Author(s):  
Sadie Williams ◽  
Matthew Leonard ◽  
Eric Hall ◽  
Jose Perez ◽  
Jacqueline Wessel ◽  
...  
Keyword(s):  
Early Onset ◽  
Complete Blood Count ◽  
Retrospective Chart Review ◽  
Antibiotic Use ◽  
Control Group ◽  
Typically Develop ◽  
Early Onset Sepsis ◽  
Mature Neutrophil ◽  
Reliable Marker ◽  
Culture Positive

Objective Gastroschisis is a congenital defect in which the abdominal viscera herniate through the abdominal wall. In this population, antibiotics are often initiated immediately following delivery; however, this may be unnecessary as infections typically develop as a consequence of chronic issues in gastroschisis. The objective of this study was to evaluate the incidence of culture positive early onset sepsis, the reliability of the immature to mature neutrophil count (I:T) ratio as an infectious biomarker, and antibiotic use in infants with gastroschisis. Study Design This retrospective chart review analyzed clinical data from 103 infants with gastroschisis and 103 weight-matched controls that were evaluated for early onset infection. Results Compared with the control group, there was a significantly increased percentage of infants with an I:T ratio > 0.2 in the gastroschisis group (43% vs. 12%, p < 0.001) and an increased percentage of infants exposed to greater than 5 days of antibiotics regardless of their I:T ratio (75% vs. 6%, p < 0.001). There were no episodes of culture positive early onset sepsis in either group. Conclusion Our results indicate that I:T ratio is not a reliable marker of infection in gastroschisis, and suggest that empiric septic evaluation and antibiotic use, immediately following delivery in gastroschisis infants, may be unnecessary.

Oral Care, Ventilator-Associated Pneumonia, and Counting Cultures

2009 ◽  
Vol 18 (6) ◽  
pp. 507-509
Author(s):  
Christelle Lizy ◽  
Nele Brusselaers ◽  
Sonia Labeau ◽  
Dominique Vandijck ◽  
David De Wandel ◽  
...  
Keyword(s):  
Oral Care ◽  
Ventilator Associated Pneumonia

scholarly journals Multicentre randomised controlled trial to investigate the usefulness of continuous pneumatic regulation of tracheal cuff pressure for reducing ventilator-associated pneumonia in mechanically ventilated severe trauma patients: the AGATE study protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017003 ◽  
Author(s):  
Nicolas Marjanovic ◽  
Denis Frasca ◽  
Karim Asehnoune ◽  
Catherine Paugam ◽  
Sigismond Lasocki ◽  
...  
Keyword(s):  
Cuff Pressure ◽  
Invasive Mechanical Ventilation ◽  
Severe Trauma ◽  
Control Group ◽  
Trauma Patients ◽  
Intermittent Control ◽  
Ventilator Associated Pneumonia ◽  
Pneumatic Device ◽  
Randomised Controlled ◽  
Tracheal Cuff

IntroductionSevere trauma represents the leading cause of mortality worldwide. While 80% of deaths occur within the first 24 hours after trauma, 20% occur later and are mainly due to healthcare-associated infections, including ventilator-associated pneumonia (VAP). Preventing underinflation of the tracheal cuff is recommended to reduce microaspiration, which plays a major role in the pathogenesis of VAP. Automatic devices facilitate the regulation of tracheal cuff pressure, and their implementation has the potential to reduce VAP. The objective of this work is to determine whether continuous regulation of tracheal cuff pressure using a pneumatic device reduces the incidence of VAP compared with intermittent control in severe trauma patients.Methods and analysisThis multicentre randomised controlled and open-label trial will include patients suffering from severe trauma who are admitted within the first 24 hours, who require invasive mechanical ventilation to longer than 48 hours. Their tracheal cuff pressure will be monitored either once every 8 hours (control group) or continuously using a pneumatic device (intervention group). The primary end point is the proportion of patients that develop VAP in the intensive care unit (ICU) at day 28. The secondary end points include the proportion of patients that develop VAP in the ICU, early (≤7 days) or late (>7 days) VAP, time until the first VAP diagnosis, the number of ventilator-free days and antibiotic-free days, the length of stay in the ICU, the proportion of patients with ventilator-associated events and that die during their ICU stay.Ethics and disseminationThis protocol has been approved by the ethics committee of Poitiers University Hospital, and will be carried out according to the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines. The results of this study will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals.Trial registrationClinical TrialsNCT02534974

Association Between a Silver-Coated Endotracheal Tube and Reduced Mortality in Patients With Ventilator-Associated Pneumonia

CHEST Journal ◽  
2010 ◽  
Vol 137 (5) ◽  
pp. 1015-1021 ◽  
Author(s):  
Bekele Afessa ◽  
Andrew F. Shorr ◽  
Antonio R. Anzueto ◽  
Donald E. Craven ◽  
Regina Schinner ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Ventilator Associated Pneumonia
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