Incidence and consequences of tracheobronchitis associated with ventilator in ICUs

Grupo de Investigadores del Proyecto Disminución de la Infección Nosocomial en U

2013, Number 1

Rev cubana med 2013; 52 (1)

Incidence and consequences of tracheobronchitis associated with ventilator in ICUs

Grupo de Investigadores del Proyecto Disminución de la Infección Nosocomial en Unidades de Cuidados Intensivos (DINUCIs)

Full text

How to cite this article

Language: Spanish
References: 19
Page: 14-24
PDF size: 69.73 Kb.

ABSTRACT

Introduction: lower respiratory infections rank first among related infections in health care intensive care units.
Objectives: to describe the incidence and consequences of stay and mortality of ventilator-associated tracheobronchitis (TAVM) in ICU.
Methods: a multicenter, descriptive, prospective and cross-sectional study was conducted in 6 adult ICU. 454 patients were studied. The study variables were collected in two databases.
Results: TAVM incidence rate: 1.76 %, relative to the total number of patients with risk factor: 6.06 %. Incidence density: 7.61 % by 1000 d with risk factor. Average stay, TAVM: 13.13 d, patients without IRCS: 5.49 d (p = 0.006). Mortality, TAVM: 25 %, VAP: 55.2 %, patients without IRCS: 14.9 % (p = 0.000).
Conclusions: TAVM is not uncommon in ICU. Its diagnosis involves increased stay and its mortality in ventilated patients. The implementation of surveillance and prevention measures is requiered.

REFERENCES

Olaechea PM, Insausti J, Blanco A, Luque P. Epidemiología e impacto de las infecciones nosocomiales. Med Intensiva. 2010;34(4):256-67.
Palomar M, Rodríguez P, Nieto M, Sancho S. Prevención de la infección nosocomial en pacientes críticos. Med Intensiva. 2010;34(8):523-33.
Rosenthal VD, Bijie H, Maki DG, Mehta Y, Apisarnthanarak A, Medeiros EA, et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009. Am J Infect Control. 2012;40(5):396-407.
Durlach R, McIlvenny G, Newcombe RG, Reid G, Doherty L, Freuler C, et al. Prevalence survey of healthcare-associated infections in Argentina; comparison with England, Wales, Northern Ireland and South Africa. J Hosp Infect. 2012;80(3):217-23.
Novosel TJ, Hodge LA, Weireter LJ, Britt RC, Collins JN, Reed SF, et al. Ventilator-associated pneumonia: depends on your definition. Am Surg. 2012;78(8):851-4.
O2 Grady NP, Murray PR, Ames N. Preventing ventilator-associated pneumonia: does the evidence support the practice? JAMA. 2012 Jun. 20;307(23):2534-9.
Ramirez P, Bassi GL, Torres A. Measures to prevent nosocomial infections during mechanical ventilation. Curr Opin Crit Care. Feb. 2012;18(1):86-92.
Nseir S, Di Pompeo C, Pronnier P, Beague S, Onimus T, Saulnier F, et al. Nosocomial tracheobronchitis in mechanically ventilated patients: incidence, aetiology and outcome. Eur Respir J. 2002;20:1483-9.
Craven DE. Ventilator-associated tracheobronchitis (VAT): questions, answers, and a new paradigm? Critical Care. 2008;12:157. [Internet]. [citado 10 Sep. 2012]. Disponible en: http://ccforum.com/content/12/3/157
Fica A, Cifuentes M, Hervé B. Neumonía asociada a ventilación mecánica. Primera parte. Aspectos diagnósticos. Rev Chil Infect. 2011;28 (2):13051.
Estudio Nacional de Vigilancia de Infección Nosocomial en Servicios de Medicina Intensiva. Informe 2010. [Internet]. 2010 [citado 10 Sep. 2012]. Disponible en: http://hws.vhebron.net/envin-helics/Help/InformeENVIN-UCI2010.pdf
Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health careassociated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309-32.
Nseir S, Di Pompeo C, Soubrier S, Lenci H, Delour P, Onimus T, et al. Effect of ventilator-associated tracheobronchitis on outcome in patients without chronic respiratory failure: a casecontrol study. Critical Care [Internet]. 2005;9:R238-R245. [citado 10 Sep. 2012] Disponible en: http://ccforum.com/content/9/3/R238
Dallas J, Skrupky L, Abebe N, Boyle WA, Kollef MH. Ventilator-associated tracheobronchitis in a mixed surgical and medical ICU population. Chest. 2011; 139(3):513-8.
Martínez G, Lonegro G, Ramundo F, Rolando L, Sarquís S, Sosa A, et al. Traqueobronquitis asociada al ventilador (TAV), implicancias del diagnóstico clínico y microbiológico en una cohorte de pacientes en ventilación mecánica. Rev Am Med Resp. 2012;1:10-16.
Nseir S. Ventilator-associated tracheobronchitis lung scan differentiate could fiberoptic bronchoscopy and CT from Ventilator-associated pneumonia? Chest. 2009;136:1187-8.
Craven DE, Hjalmarson KI. Ventilator-Associated Tracheobronchitis and Pneumonia: Thinking Outside the Box. Clin Infect Diseases. 2010;51(S1):S59S66.
Wunderink RG. Ventilator-Associated Tracheobronchitis. Public-Reporting Scam or Important Clinical Infection? Chest. 2011;139(3):485-8.
Niederman MS. Hospital-acquired pneumonia, Health careassociated pneumonia, Ventilator-associated pneumonia, and Ventilator-associated tracheobronchitis: Definitions and challenges in trial design. Clin Infect Diseases. 2010;51(S1):S12S17.