6,032 results match your criteria Ventilator-Associated Pneumonia
Infect Drug Resist 2018 13;11:2249-2255. Epub 2018 Nov 13.
Department of Emergency, Shengjing Hospital Affiliated to China Medical University, Heping District, Shenyang, Liaoning Province 110004, People's Republic of China,
Purpose: To study the distribution of pathogenic bacteria in ventilator-associated pneumonia (VAP), and epidemiological characteristics of extended-spectrum β lactamase (ESBL)-producing bacteria.
Patients And Methods: Lower respiratory tract secretions from 156 patients with mechanical ventilation were collected using a protective specimen brush (PSB), with quantitative bacterial culture carried out and antibiotic sensitivity measured. ESBLs produced by Gram-negative bacilli were detected using the double disk diffusion method and monitored by plasmid profiles. Read More
Crit Care 2018 Dec 5;22(1):333. Epub 2018 Dec 5.
Division of Infectious Diseases, Department of Medicine, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE, 68135, USA.
Crit Care Med 2018 Nov 30. Epub 2018 Nov 30.
Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany.
Objectives: The detection of microbial volatile organic compounds or host response markers in the exhaled gas could give an earlier diagnosis of ventilator-associated pneumonia. Gas chromatography-ion mobility spectrometry enables noninvasive, rapid, and sensitive analysis of exhaled gas. Using a rabbit model of ventilator-associated pneumonia we determined if gas chromatography-ion mobility spectrometry is able to detect 1) ventilator-associated pneumonia specific changes and 2) bacterial species-specific changes in the exhaled gas. Read More
J Adv Nurs 2018 Dec 3. Epub 2018 Dec 3.
Orlando Health, Orlando, FL.
Aim: The primary aim of this study is to compare an oropharyngeal suction intervention versus usual care on microaspiration in intubated patients. Secondary aims are to evaluate the intervention on ventilator associated condition rates, time to occurrence and compare tracheal-oral α-amylase ratios between groups.
Design: Prospective randomized clinical trial. Read More
Nurs Crit Care 2018 Dec 2. Epub 2018 Dec 2.
The Critical Care Department, The Queen Elizabeth Hospital, King's Lynn, UK.
Background: Endotracheal tube cuff pressures should be maintained between 20 and 30 cm H O to prevent the aspiration of subglottic secretions past the cuff. Guidance recommends regular monitoring of the cuff pressure, performed using a handheld manometer/inflator. Poor technique can lead to transient deflation of the cuff, leading to the bolus aspiration of upper respiratory tract secretions, tracheal colonization and, ultimately, ventilator-associated pneumonia. Read More
Crit Care Nurse 2018 Dec;38(6):36-45
Cheryl Lynne McBeth is a nurse manager for the pediatric intensive care unit (PICU), pediatric cardiac intensive care unit (PCICU), and Critical Care Transport Team, University of California, Davis, Children's Hospital, Sacramento, California. Rosa Solis Montes is clinical nurse III, University of California, Davis, Children's Hospital. She has been the cochair or chair of the No VAP committee since 2010. Amy Powne is Fetal Care and Treatment Center registered nurse coordinator at University of California, Davis, Children's Hospital. Sopon Elizabeth North is clinical nurse III, University of California, Davis, Children's Hospital. She currently is chair of the PICU/PCICU Hospital-Acquired Infection Committee. JoAnne E. Natale is professor of clinical pediatrics, Pediatric Critical Care, Children's Hospital Quality & Safety, and director of quality and safety, University of California, Davis, Medical Center.
Background: Ventilator-associated pneumonia (VAP) increases morbidity, mortality, and health care costs.
Objective: To reduce the VAP rate in the pediatric/cardiac intensive care unit to fewer than 2 events per 1000 ventilator days within 2 years and to sustain a rate near 0 for the next 5 years.
Methods: An evidence-based VAP prevention bundle was developed and implemented by an interprofessional team using the Six Sigma Define, Measure, Analyze, Improve, Control methodology. Read More
BMC Anesthesiol 2018 Dec 3;18(1):181. Epub 2018 Dec 3.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
Background: Microaspiration past the tracheal tube cuffs causes ventilator-associated pneumonia. The objective of the current study was to evaluate whether creating negative pressure between the tracheal double cuffs could block the fluid passage past the tracheal tube cuffs.
Methods: A new negative pressure system was devised between the double cuffs through a suction hole in the intercuff space. Read More
Dimens Crit Care Nurs 2019 Jan/Feb;38(1):5-12
Mahmoud Ali Alja'afreh, RN, PhD, is an assistant professor, vice dean, and head of the Adult Health Nursing Department, Faculty of Nursing, Mutah University, Mutah, Karak, Jordan. His research interest is focused on four major areas: (1) studying of patient and family satisfaction in acute and critical care settings; (2) use of local resources to develop student center knowledge about disaster education; (3) development of patient safety guidelines for pressure ulcers patients, mechanically ventilated patients, and critical care practices issues; and (4) reshaping and enforcement of structures, processes, and outcomes of risk assessment, and management of pressure ulcers patients and critical care/cancer patients. Sultan Mosleh, RN, PhD, is an associate professor and a former head of the Adult Health Nursing Department, Faculty of Nursing, Mutah University, Jordan. His research interest is focused on four major areas: (1) critical care environment issues for patients and staff; (2) palliative care and end-of-life care of cancer patients; (3) clinical cardiac patients' rehabilitation; and (4) patient and nursing education. Sakhaa S. Habashneh, RN, MsN, is a lecturer at the Department of Adult Health Nursing, Faculty of Nursing, University of Mutah, Mutah, Karak, Jordan. Her research interest is focused on four major areas: (1) clinical critical nursing issues; (2) knowledge and compliances of critical care units' staff; and (3) patient and nursing education.
Purpose: This study aims to evaluate the effects of oral care protocol on the incidence of ventilator-associated pneumonia (VAP) at selected intensive care units (ICUs) in Jordan using clinical pulmonary infection score.
Methods: A quasi-experimental design was used, and 1 large teaching hospital from the Jordanian capital, along with 2 hospitals from the southern region, was selected. A total of 218 patients participated, among which VAP risk in 2 independent groups was evaluated through the Clinical Pulmonary Infection Score sheet. Read More
J Lab Physicians 2018 Oct-Dec;10(4):406-409
Division of Trauma Surgery and Critical Care, JPNATC, AIIMS, New Delhi, India.
Introduction: Device-associated infections constitute the majority of health-care infections in Intensive Care Units (ICUs). Trauma patients are more prone to acquire such infections; ventilator-associated pneumonia (VAP) being the most common Health care associated infections (HAI) in ICU has serious implications such as increased morbidity, prolonged hospital stay, and mortality. This study aims to compare the clinicomicrobiological profile of VAP and non-VAP trauma patients at Level I trauma center. Read More
PLoS One 2018 27;13(11):e0208361. Epub 2018 Nov 27.
[This corrects the article DOI: 10.1371/journal.pone. Read More
Int J Antimicrob Agents 2018 Nov 22. Epub 2018 Nov 22.
Centre for Translational Anti-Infective Pharmacodynamics, School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland 4006, Australia.
Background: . Knowledge of antibiotic concentrations achievable in the epithelial lining fluid (ELF) will help guide antibiotic dosing for treating patients with gram-negative bacillary ventilator-associated pneumonia (VAP).
Objective: . Read More
Inflammation 2018 Nov 22. Epub 2018 Nov 22.
Department of Anesthesiology, the First Hospital of Fujian Medical University, Fuzhou, 350005, China.
Ventilator-induced lung injury (VILI) is one of the most serious complications of mechanical ventilation (MV) and can increase the mortality of patients with acute respiratory distress syndrome (ARDS). This work aimed to test the hypothesis that the anti-inflammatory properties of human interleukin-10 (hIL-10) can reduce VILI. Thirty-six healthy male Sprague-Dawley rats were randomly assigned into three groups (n = 12) as follows: a control group, a VILI group, and a hIL-10 group. Read More
Expert Rev Respir Med 2018 Nov 21:1-14. Epub 2018 Nov 21.
d Clinical Research/epidemiology In Pneumonia & Sepsis , Vall d'Hebron Institut of Research & Centro de Investigacion Biomedica en Red (CIBERES) , Barcelona , Spain.
Introduction: Intubation is required to maintain the airways in comatose patients and enhance oxygenation in hypoxemic or ventilation in hypercapnic subjects. Recently, the Centers of Disease Control (CDC) created new surveillance definitions designed to identify complications associated with poor outcomes. Areas covered: The new framework proposed by CDC, Ventilator-Associated Events (VAE), has a range of definitions encompassing Ventilator-Associated Conditions (VAC), Infection-related Ventilator-Associated Complications (IVAC), or Possible Ventilator-Associated Pneumonia - suggesting replacing the traditional definitions of Ventilator-Associated Tracheobronchitis (VAT) and Ventilator-Associated Pneumonia (VAP). Read More
Int J Prev Med 2018 12;9:93. Epub 2018 Oct 12.
Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Background: Pneumonia is one of the most common hospital-acquired infections among bedridden patients in Intensive Care Units (ICUs). Colonization of mouth and pharynx by pathogenic bacteria and their aspiration into the lower respiratory tract is an important step in pathogenesis of hospital-acquired pneumonia. The purpose of this study was to compare the effects of chlorhexidine and potassium permanganate mouthwashes in preventing incidence of hospital-acquired pneumonia in hospitalized patients in the ICU. Read More
Rom J Intern Med 2018 Nov 15. Epub 2018 Nov 15.
Department of Anesthesiology and critical care, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Background And Objective: Vitamin D deficiency is considered one of the most common nutritional deficiencies associated with weakened immune system and increased likelihood of sepsis. The current study was conducted to investigate the association between serum vitamin D level and the severity and prognosis of ventilator associated pneumonia (VAP) in inpatients in intensive care unit (ICU).
Methods: Eighty-four consecutive patients with VAP were enrolled in this observational, prospective study conducted in the ICU of Besat Hospital, Hamadan. Read More
Crit Care 2018 Nov 15;22(1):301. Epub 2018 Nov 15.
Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Background: Aerosolized antibiotics have been proposed as a novel and promising treatment option for the treatment of ventilator-associated pneumonia (VAP). However, the optimum aerosolized antibiotics for VAP remain uncertain.
Methods: We included studies from two systematic reviews and searched PubMed, EMBASE, and Cochrane databases for other studies. Read More
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Oct;30(10):950-952
Department of Intensive Care Unit, Pingxiang People's Hospital, Pingxiang 337000, Jiangxi, China. Corresponding author: Guo Kun, Email:
Objective: To explore the efficacy of comfort analgesia and sedation in patients with mechanical ventilation in intensive care unit (ICU).
Methods: Eighty patients with mechanical ventilation admitted to ICU of Pingxiang People's Hospital from June 2017 to May 2018 were enrolled, and they were randomly divided into control group and observation group by random number table method, with 40 patients in each group. The control group was given a daily analgesic and sedation regimen with critical-care pain observation tool (CPOT) 0-3 and Richmond agitation-sedation scale (RASS) maintained at -3 to -4. Read More
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Oct;30(10):933-938
Department of ICU, Shexian People's Hospital, Huangshan 245200, Anhui, China (Hu ZC); Department of ICU, First Affiliated Hospital of China University of Science and Technology, Hefei 230001, Anhui, China (Zhou SS). Corresponding author: Zhou Shusheng, Email:
Objective: To investigate the risk factors of ventilator-associated pneumonia (VAP) and the distribution and drug resistance of pathogens in intensive care unit (ICU) of county hospital.
Methods: 234 patients on mechanical ventilation for more than 48 hours admitted to ICU of Shexian People's Hospital of Huangshan City from January 2016 to June 2018 were enrolled. The clinical data of all patients including gender, age, past medical history, exposure to antibiotics, medication, the duration of mechanical ventilation, the length of ICU stay, serum albumin, tracheotomy, re-intubation, prognosis, and pathogenic bacteria and drug sensitivity test of VAP patients were collected. Read More
Clin Infect Dis 2018 Nov;67(suppl_2):S153-S161
Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing.
Background: Ventilator-associated pneumonia (VAP) is among the most important hospital-acquired infections in the intensive-care unit setting. However, clinical data regarding the epidemiology of VAP in China are limited.
Methods: A multicenter, longitudinal, observational study was performed from March 2013 to December 2015 to prospectively collect data on patients diagnosed with VAP. Read More
Clin Infect Dis 2018 Nov;67(suppl_2):S146-S152
Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University.
Background: The microbial etiology and mortality risk factors of ventilator-associated pneumonia (VAP) have not been investigated extensively in Shanghai.
Methods: VAP cases were identified from the patients hospitalized during the period from 1 January 2013 to 30 December 2017 in Shanghai. The relevant data were reviewed and analyzed retrospectively. Read More
J Crit Care 2019 Feb 3;49:124-128. Epub 2018 Nov 3.
Intensive Care Unit, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil; Infection Control Unit, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.
Introduction: Acinetobacter species treatment often represents a challenge. The main objective of this study is identify predictors of ICU mortality in patients submitted to mechanical ventilation (MV).
Materials And Methods: Retrospective cohort study. Read More
Can J Surg 2018 12;61(6):S208-S218
From the Department of National Defense, Royal Canadian Medical Services, Ottawa, Ont. (Kao); Critical Care Western, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Kao, Martin, Rui); and the Centre for Critical Illness Research, Lawson Health Research Institute, London, Ont. (Kao, Martin, Rui).
Background: Acute lung contusion from blunt chest trauma (BCT) is characterized by an intense inflammatory response in the pulmonary parenchyma, which is associated with acute lung injury (ALI), acute respiratory distress syndrome and ventilator-associated pneumonia. We hypothesized that aerosolized indomethacin may reduce pulmonary inflammation and ALI in a rat model of BCT.
Methods: Sprague-Dawley rats were anesthetized and received a tracheotomy for administration of aerosolized medication through a catheter. Read More
Int J Antimicrob Agents 2018 Nov 8. Epub 2018 Nov 8.
Infectious Diseases Clinic, Department of Medicine University of Udine and Azienda Sanitaria Universitaria Integrata, Udine, Italy; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.. Electronic address:
To describe the largest clinical experience using ceftolozane-tazobactam (C/T) for treatment of different type of Pseudomonas aeruginosa infections. A retrospective study was performed at 22 hospitals in Italy from June 2016 to March 2018. All adult patients treated with at least 4 days of C/T were enrolled. Read More
Infect Control Hosp Epidemiol 2018 Nov 9:1-8. Epub 2018 Nov 9.
1Department of Population Medicine,Harvard Pilgrim Health Care Institute and Harvard Medical School,Boston,Massachusetts.
Objective: To assess variability in antimicrobial use and associations with infection testing in pediatric ventilator-associated events (VAEs).
Design: Descriptive retrospective cohort with nested case-control study.
Setting: Pediatric intensive care units (PICUs), cardiac intensive care units (CICUs), and neonatal intensive care units (NICUs) in 6 US hospitals. Read More
Trials 2018 Nov 8;19(1):614. Epub 2018 Nov 8.
Department of Clinical Epidemiology, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
Background: Optimising the use of antibiotic agents is a pressing challenge to overcoming the rapid emergence and spread of multidrug-resistant pathogens in intensive care units (ICUs). Although Gram staining may possibly provide immediate information for predicting pathogenic bacteria, Gram stain-guided initial antibiotic treatment is not well established in the ICU setting. We planned the GRam stain-guided Antibiotics ChoicE for Ventilator-Associated Pneumonia (GRACE-VAP) trial to investigate whether Gram staining can safely restrict the use of broad-spectrum antibiotics in patients with ventilator-associated pneumonia (VAP), which is one of the most common hospital-acquired infections in ICUs. Read More
Crit Care Med 2018 Nov 7. Epub 2018 Nov 7.
UMR 1137, IAME, Université Paris Diderot, Paris, France.
Objectives: To investigate the respective impact of ventilator-associated pneumonia and ICU-hospital-acquired pneumonia on the 30-day mortality of ICU patients.
Design: Longitudinal prospective studies.
Setting: French ICUs. Read More
Med Sci (Paris) 2018 Oct 7;34 Focus issue F1:26-32. Epub 2018 Nov 7.
Department of ICU, Zhejiang Hospital. No 12. Lingyin Road, Hangzhou City, Zhejiang Province, 317000 PR China.
Objective: The aim of this study was to evaluate the diagnostic efficacy of serum procalcitonin (PCT), c-reactive protein (CRP) concentration and clinical pulmonary infection score(CPIS) in ventilator-associated pneumonia(VAP).
Methods: Forty-nine patients who were admitted to the intensive care unit (ICU) of Zhejiang Hospital with suspected VAP were recruited in this study. The serum level of PCT and CRP of all patients were measured and CPIS was calculated at the time of VAP suspected diagnosis. Read More
Med Intensiva 2018 Nov 2. Epub 2018 Nov 2.
Unidad Clínica de Cuidados Intensivos, Hospital Universitario Virgen Macarena, Sevilla, España. Electronic address:
Lower respiratory tract infections in the intubated patient constitute a serious health problem due to their associated morbidity and mortality. Microaspiration of the buccopharyngeal secretions is the main physiopathological mechanism underlying the development of pneumonia and tracheobronchitis in intubated patients. All care bundles designed to prevent these infections include the use of antiseptics to reduce buccopharyngeal colonization. Read More
Clin Chest Med 2018 Dec;39(4):823-836
Service de Réanimation Médicale, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83 Boulevard de l'Hôpital, Paris Cedex 13 75651, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS_1166-ICAN Institute of Cardiometabolism and Nutrition, Paris, France. Electronic address:
Antibiotic aerosolization in patients with ventilator-associated pneumonia (VAP) allows very high concentrations of antimicrobial agents in the respiratory secretions, far more than those achievable using the intravenous route. However, data in critically ill patients with pneumonia are limited. Administration of aerosolized antibiotics might increase the likelihood of clinical resolution, but no significant improvements in important outcomes have been consistently documented. Read More
Clin Chest Med 2018 Dec;39(4):809-822
Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8052, St Louis, MO 63110, USA. Electronic address:
Ventilator-associated pneumonia (VAP) remains a significant clinical entity with reported incidence rates of 7% to 15%. Given the considerable adverse consequences associated with this infection, VAP prevention became a core measure required in most US hospitals. Many institutions implemented effective VAP prevention bundles that combined head of bed elevation, hand hygiene, chlorhexidine oral care, and subglottic drainage. Read More
Clin Chest Med 2018 Dec;39(4):797-808
Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE 68198, USA.
Two recent major guidelines on diagnosis and treatment of ventilator-associated pneumonia (VAP) recommend consideration of local antibiotic resistance patterns and individual patient risks for resistant pathogens when formulating an initial empiric antibiotic regimen. One recommends against invasive diagnostic techniques with quantitative cultures to determine the cause of VAP; the other recommends either invasive or noninvasive techniques. Both guidelines recommend short-course therapy be used for most patients with VAP. Read More
Clin Chest Med 2018 Dec;39(4):785-796
Department of Anaesthesia and Critical Care Medicine, St. James's Hospital, James's Street, Dublin 8, Ireland; Multidisciplinary Intensive Care Research Organization (MICRO), St James's Hospital, James's Street, Dublin 8, Ireland; Trinity Centre for Health Sciences, James's Street, Dublin 8, Ireland. Electronic address:
Ventilator-associated tracheobronchitis (VAT) might represent an intermediate process between lower respiratory tract colonization and ventilator-associated pneumonia (VAP), or even a less severe spectrum of VAP. There is an urgent need for new concepts in the arena of ventilator-associated lower respiratory tract infections. Ideally, the gold standard of care is based on prevention rather than treatment of respiratory infection. Read More
Clin Chest Med 2018 Dec;39(4):775-783
CHU Lille, Critical Care Center, bd du Pr Leclercq, Lille F-59000, France; Lille University, Medicine School, 1 Place de Verdun, Lille F-59000, France. Electronic address:
Airway devices play a major role in the pathogenesis of microaspiration of contaminated oropharyngeal and gastric secretions, tracheobronchial colonization, and ventilator-associated pneumonia (VAP) occurrence. Subglottic secretion drainage is an effective measure for VAP prevention, and no routine change of ventilator circuit. Continuous control of cuff pressure, silver-coated tracheal tubes, low-volume low-pressure tracheal tubes, and the mucus shaver are promising devices that should be further evaluated by large randomized controlled trials. Read More
Clin Chest Med 2018 Dec;39(4):691-701
Division of Pulmonary, Critical Care, and Sleep Medicine, Rush University Medical Center, Rush Medical College, 1725 West Harrison Street Suite 054, Chicago, IL 60612, USA. Electronic address:
Biomarkers are used in the diagnosis, severity determination, and prognosis for patients with community-acquired pneumonia (CAP). Selected biomarkers may indicate a bacterial infection and need for antibiotic therapy (C-reactive protein, procalcitonin, soluble triggering receptor expressed on myeloid cells). Biomarkers can differentiate CAP patients who require hospital admission and severe CAP requiring intensive care unit admission. Read More
Appl Nurs Res 2018 Dec 19;44:48-53. Epub 2018 Sep 19.
California State University, School of Nursing, Sacramento, United States of America.
Consistently delivered, effective oral care targets bacterial multiplication reducing the risk of non-ventilator associated hospital acquired pneumonia (NV-HAP).
Aim: Determine the effect of a twice daily oral care initiative on the incidence and cost of NV-HAP.
Methods: This single arm intervention study used pre/post population data to determine the effectiveness of a universal, standardized oral care protocol vs. Read More
Iran J Nurs Midwifery Res 2018 Nov-Dec;23(6):486-490
Critical Care Nursing Department, Nursing and Midwifery School, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Background: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections that increase mortality rate and the length of hospitalization. Oral care can improve patient's oral health, however, the role of oral care in the reduction in incidence rate of VAP is indisputable. The aim of this study was to investigate the effect of oral care on the frequency of VAP of patients in intensive care unit. Read More
Medicine (Baltimore) 2018 Nov;97(44):e13025
Hematology Unit, Medical Specialty Center, Bangkok Hospital Hat Yai, Bangkok Dusit Medical Services, Hat Yai, Songkhla, Thailand.
Rationale: Thrombotic thrombocytopenic purpura (TTP) and hemophagocytic lymphohistiocytosis (HLH) are rare hematologic conditions and have high mortality. Both TTP and HLH result from deregulation of the immune system. There are no published reports of coexisting TTP and HLH in elderly patients. Read More
Intensive Care Med 2018 Dec 31;44(12):2192-2204. Epub 2018 Oct 31.
Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Purpose: A systematic review and meta-analysis was conducted to answer the question 'In adults with respiratory failure requiring invasive ventilation for more than 24 h, does a weaning strategy with early extubation to non-invasive ventilation (NIV) compared to invasive ventilation weaning reduce all-cause hospital mortality?'
Methods: We included randomised and quasi-randomised controlled trials that evaluated the use of non-invasive ventilation, compared to invasive ventilation, as a weaning strategy in adults mechanically ventilated for at least 24 h. The EMBASE, MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) bibliographic databases were searched from inception to February 2018. Bayesian hierarchical models were used to perform the meta-analysis. Read More
PLoS One 2018 31;13(10):e0206760. Epub 2018 Oct 31.
Wellcome Trust Asia Programme, Oxford University Clinical Research Unit, Hanoi, Vietnam.
Introduction: Ventilator associated respiratory infections (VARIs) are the most common hospital acquired infections in critical care worldwide. This work aims to estimate the total annual direct hospital cost of treating VARI throughout Vietnam.
Methods: A costing model was constructed to evaluate the excess cost of diagnostics and treatment of VARI in Vietnam. Read More
J Antimicrob Chemother 2018 Oct 29. Epub 2018 Oct 29.
Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Background: In vitro and clinical studies using parenteral fosfomycin have suggested the possibility of using this drug against infections caused by MDR microorganisms. The aim of this study was to describe a case series of patients treated with fosfomycin who had severe infections caused by pan-drug-resistant Gram-negative bacteria.
Methods: We describe a prospective series of cases of hospitalized patients with infections caused by Gram-negative bacteria resistant to β-lactams and colistin, treated with 16 g of fosfomycin daily for 10-14 days. Read More
Antimicrob Agents Chemother 2018 Oct 29. Epub 2018 Oct 29.
JMI Laboratories, North Liberty, Iowa, USA.
Ceftobiprole is an advanced cephalosporin with potent activity against Gram-positive and Gram-negative bacteria that is approved in many European and non-European countries to treat community- and hospital-acquired pneumonia (excluding ventilator-associated pneumonia). This study reports on the activity of ceftobiprole against a large set of clinical isolates from hospitalized patients in the United States in 2016 that caused serious infections including pneumonia, bacteremia, and skin and skin structure infections. To assess any potential temporal changes in ceftobiprole activity, the 2016 results were compared to corresponding MIC data from a 2006 U. Read More
BMC Res Notes 2018 Oct 29;11(1):769. Epub 2018 Oct 29.
University of Technology Sydney, Broadway, NSW, 2007, Australia.
Objective: To examine anti-microbial prescribing practices associated with ventilator-associated pneumonia from data gathered during an audit of practice and outcomes in intensive care units (ICUs) in a previously published study.
Results: The patient sample of 169 was 65% male with an average age of 59.7 years, a mean APACHE II score of 20. Read More
Am J Respir Crit Care Med 2018 Oct 29. Epub 2018 Oct 29.
Hopital Ambroise-Pare, 55059, Medical I.C.U. - Paris west University, Boulogne-Billancourt, France.
Point-of-care ultrasound is increasingly used at the bedside to integrate the clinical assessment of the critically ill; in particular, lung ultrasound greatly developed in the last decade. This review describes basic lung ultrasound signs and focuses on their applications in critical care. Lung semiotic is made both of artifacts (derived by air/tissue interface) and real images (i. Read More
Front Pediatr 2018 12;6:294. Epub 2018 Oct 12.
Department of Pediatrics, Children's Hospital Lucerne, Lucerne, Switzerland.
Antimicrobial stewardship (AMS) is an important strategy of quality improvement for every hospital. Leadership is an important factor for implementation of quality improvement and AMS programs. Recent publications show successful AMS programs in children's hospitals, but successful implementation is often difficult to achieve and literature of AMS in neonatal and pediatric intensive care units (NICU/PICU) is scarce. Read More
Crit Care 2018 Oct 28;22(1):272. Epub 2018 Oct 28.
Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care, Uppsala University Hospital, Uppsala, Sweden.
Background: Pathogenic enteric bacteria aspirated from the oropharynx are the main cause of ventilator-associated pneumonia (VAP). Using chlorhexidine (CHX) orally or selective decontamination has been shown to reduce VAP. In a pilot study we found that oral care with the probiotic bacterium Lactobacillus plantarum 299 (Lp299) was as effective as CHX in reducing enteric bacteria in the oropharynx. Read More
Intensive Crit Care Nurs 2018 Oct 23. Epub 2018 Oct 23.
Centro Hospitalar S. João, E.P.E., Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
Objective: Ventilator associated pneumonia is the most frequent health-care-associated infection in Intensive Care Units, causing increased antibiotic consumption and resistance, length of stay, plus multiple health and economic costs. The aim of the study was to assess whether a customised guideline implementation would improve ventilator-associated pneumonia incidence and associated intensive care outcomes.
Design: This was a quasi-experimental, before-after study consisting of pre-intervention, intervention and post-intervention periods. Read More
Georgian Med News 2018 Sep(282):113-116
Tbilisi State Medical University, Department of Infectious Diseases; National Center for Disease Control and Public Health, Tbilisi, Georgia.
Bloodstream infections (BSIs) are associated with a high mortality rate, additional hospital days and excess hospital costs. Intensive Care Unit (ICU) patients are at high risk of nosocomial BSIs because of their weakened condition caused by underlying disease, frequent invasive diagnostic and therapeutic procedures. Catheterization is the most common cause of hospital-acquired BSIs. Read More
Int Arch Otorhinolaryngol 2018 Oct 9;22(4):437-442. Epub 2018 Aug 9.
Department of Otolaryngology, Al-Mustansiriya University, College of Medicine, Baghdad, Iraq.
The ideal timing of tracheostomy in intensive care units (ICUs) for critically ill patients undergoing prolonged mechanical ventilation (MV) is still a controversial issue. To determine the proper timing of tracheostomy and its impact on various clinical outcomes of adult patients in ICUs undergoing prolonged MV. The present study consisted of a sample of 67 ICU adult patients who were submitted to open surgical tracheostomy and divided into two groups: 30 patients in the early tracheostomy (ET) group (within 1-10 days post intubation), and 37 patients in the late tracheostomy (LT) group (within 11-21 days post intubation). Read More
Infect Control Hosp Epidemiol 2018 Oct 25. Epub 2018 Oct 25.