6,238 results match your criteria Ventilator-Associated Pneumonia


Worldwide variation in Pseudomonas associated ventilator associated pneumonia. A meta-regression.

Authors:
James C Hurley

J Crit Care 2019 Feb 6;51:88-93. Epub 2019 Feb 6.

Department of Rural Health, Melbourne Medical School, University of Melbourne, Internal Medicine Service, Ballarat Health Services, Victoria, Australia. Electronic address:

Purpose: The objective here is to define the extent and possible reasons for geographic variation in Pseudomonas aeruginosa associated with Ventilator Associated Pneumonia (VAP).

Methods: A random effects meta-regression model of Pseudomonas associated VAP incidence within the published literature was undertaken incorporating group level factors such trauma admission, year of publication and use of bronchoscopic sampling towards VAP diagnosis.

Results: Pseudomonas associated VAP incidence was reported in 162 studies from seven worldwide regions published over 30 years. Read More

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http://dx.doi.org/10.1016/j.jcrc.2019.02.001DOI Listing
February 2019

Increased Healthcare-Associated Infections in a Surgical Intensive Care Unit Related to Boarding Non-Surgical Patients.

Surg Infect (Larchmt) 2019 Feb 15. Epub 2019 Feb 15.

3 Department of Surgery, Division of Acute Care Surgery Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.

Background: Hospital over-capacity often forces boarding patients outside of their designated intensive care unit (ICU). Anecdotal evidence suggested medical intensive care unit (MICU) patients boarding in the surgical intensive care unit (SICU) were responsible for increases in healthcare-associated infection (HAI) rates. We studied the effect of ICU boarding on rates of SICU HAIs. Read More

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https://www.liebertpub.com/doi/10.1089/sur.2018.240
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http://dx.doi.org/10.1089/sur.2018.240DOI Listing
February 2019
1 Read

Current place of probiotics for VAP.

Crit Care 2019 Feb 13;23(1):46. Epub 2019 Feb 13.

Department of Medicine, Division of Infectious Diseases, Center for Experimental and Molecular Medicine, Amsterdam Infection & Immunity Institute, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Room F0-117, Amsterdam, 1105 AZ, The Netherlands.

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http://dx.doi.org/10.1186/s13054-019-2325-9DOI Listing
February 2019

Ceftazidime/avibactam resistance associated with L169P mutation in the omega loop of KPC-2.

J Antimicrob Chemother 2019 Feb 7. Epub 2019 Feb 7.

Accelerate Diagnostics, Tucson, AZ, USA.

Objectives: Ceftazidime/avibactam resistance due to mutation in the omega loop of KPC-2 has been documented in vitro and in vivo. This study evaluated the mechanism of ceftazidime/avibactam resistance in a KPC-2-expressing Klebsiella pneumoniae isolated from a patient following ceftazidime/avibactam combination therapy with gentamicin for the treatment of ventilator-associated pneumonia.

Methods: Ceftazidime/avibactam-susceptible and -resistant isolates of K. Read More

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http://dx.doi.org/10.1093/jac/dkz026DOI Listing
February 2019

Is selective decontamination (SDD/SOD) safe in the ICU context?

Authors:
James C Hurley

J Antimicrob Chemother 2019 Feb 7. Epub 2019 Feb 7.

Rural Health Academic Center, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.

Multiple individual studies of selective digestive decontamination/selective oropharyngeal decontamination (SDD/SOD) among ICU patients appear to show potent infection prevention effects. Surprisingly, the event rates for multiple endpoints including ventilator-associated pneumonia, bacteraemia and candidaemia among concurrent control groups within SDD/SOD studies appear unusually high versus other rates in the literature. These paradoxical observations raise concern that the contextual effects of SDD/SOD, as postulated in the original SDD/SOD study, not only exist but also are strong. Read More

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http://dx.doi.org/10.1093/jac/dky573DOI Listing
February 2019

High incidence of MDR and XDR Pseudomonas aeruginosa isolates obtained from patients with ventilator-associated pneumonia in Greece, Italy and Spain as part of the MagicBullet clinical trial.

J Antimicrob Chemother 2019 Feb 8. Epub 2019 Feb 8.

Microbiology Department, Biomedical Research Institute A Coruña (INIBIC), University Hospital A Coruña (CHUAC), University of A Coruña (UDC), A Coruña, Spain.

Objectives: To characterize the antimicrobial susceptibility, molecular epidemiology and carbapenem resistance mechanisms in Pseudomonas aeruginosa isolates recovered from respiratory tract samples from patients with ventilator-associated pneumonia enrolled in the MagicBullet clinical trial.

Methods: Isolates were collected from 53 patients from 12 hospitals in Spain, Italy and Greece. Susceptibility was determined using broth microdilution and Etest. Read More

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http://dx.doi.org/10.1093/jac/dkz030DOI Listing
February 2019
2 Reads

Results from a Quality Improvement Project to Decrease Infection-Related Ventilator Events in Trauma Patients at a Community Teaching Hospital.

Am Surg 2018 Oct;84(10):1701-1704

Department of Surgery, Kern Medical Center, Bakersfield, California, USA.

Ventilator-associated pneumonia (VAP) is linked to increased morbidity and mortality and clinical protocols (VAP bundles) have evolved to minimize VAP. In 2009, a quality improvement project was implemented at our institution to decrease VAP rates in adult trauma patients. A VAP prevention committee was developed, and formal evidence-based education for the nursing and physician staff was introduced. Read More

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October 2018

Structure and Function of a Trauma Intensive Care Unit: a Report From the Trauma Icu Prevalence Project (TRIPP).

J Trauma Acute Care Surg 2019 Feb 7. Epub 2019 Feb 7.

Department of Surgery Inova Fairfax Hospital 3300 Gallows Road Falls Church, VA 22042.

Background: Specialized trauma ICU (TICU) care impacts patient outcomes. Few studies describe where and how TICU care is delivered. We performed an assessment of TICU structure and function at a sample of U. Read More

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http://dx.doi.org/10.1097/TA.0000000000002223DOI Listing
February 2019
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Ten-year surveillance study of ventilator-associated pneumonia at a tertiary care center in Lebanon.

J Infect Public Health 2019 Feb 5. Epub 2019 Feb 5.

Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon; Infection Control and Prevention Program, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address:

Background: Ventilator-associated pneumonia (VAP) is associated with significant adverse outcomes in critically-ill patients admitted to the Intensive Care Unit (ICU). Systematic data from Lebanon on VAP are not available and large epidemiological studies from the region are scarce.

Methods: We conducted a retrospective study over a 10-year period at the American University of Beirut Medical Center (AUBMC), a tertiary referral center in Lebanon in order to describe the incidence, microbiology, and temporal trends of VAP in the medical/surgical ICU. Read More

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http://dx.doi.org/10.1016/j.jiph.2019.01.057DOI Listing
February 2019
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Outcomes in cystic fibrosis lung transplant recipients infected with organisms labeled as pan-resistant: An ISHLT Registry‒based analysis.

J Heart Lung Transplant 2019 Jan 25. Epub 2019 Jan 25.

Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, California, USA. Electronic address:

Background: The presence of pan-resistant organisms in patients with cystic fibrosis (CF) potentially impacts mortality after lung transplant (LT). In this study we aimed to study LT mortality in CF patients with and without pan-resistant infection.

Methods: The International Society for Heart and Lung Transplantation (ISHLT) Thoracic Transplant Registry was used to identify adults with CF, first-time, bilateral LT from 1991 to 2015. Read More

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http://dx.doi.org/10.1016/j.healun.2019.01.1306DOI Listing
January 2019
1 Read

Severe thoracic trauma caused left pneumonectomy complicated by right traumatic wet lung, reversed by extracorporeal membrane oxygenation support-a case report.

BMC Pulm Med 2019 Feb 6;19(1):30. Epub 2019 Feb 6.

Critical Care Medicine Department of The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China.

Background: Double lumen intubation and one-lung ventilation should be applied without delay in cases of traumatic main bronchial rupture. In most cases, when the patients' vital signs have been stabilized, the repair can be performed. However, when one-lung ventilation is complicated by traumatic wet lung, the mortality rate is likely to be much higher. Read More

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http://dx.doi.org/10.1186/s12890-019-0790-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366044PMC
February 2019
1 Read

Type 2 diabetes and postoperative pneumonia: An observational, population-based study using the Spanish Hospital Discharge Database, 2001-2015.

PLoS One 2019 6;14(2):e0211230. Epub 2019 Feb 6.

Preventive Medicine and Public Health Teaching and Research Unit. Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain.

Purpose: We analyzed temporal trends, demographic and clinical characteristics and hospital mortality rates of postoperative pneumonia among type 2 diabetes mellitus (T2DM) patients in Spain from 2001 to 2015. We also compared the incidence, comorbidities and mortality between patients with and without T2DM suffering from postoperative pneumonia. Finally, we analyzed the factors involved in the prediction of in-hospital mortality among patients suffering postoperative pneumonia. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0211230PLOS
February 2019
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Elaboration of consensus clinical endpoints to evaluate antimicrobial treatment efficacy in future HABP/VABP clinical trials.

Clin Infect Dis 2019 Feb 4. Epub 2019 Feb 4.

Jean-François Timsit, APHP Medical and Infectious Diseases ICU, Bichat Hospital, Paris, France UMR 1137 IAME Inserm/Université Paris Diderot, Paris, France.

Background: Randomized Clinical Trials (RCTs) in Hospital-Acquired (HABP) and Ventilator-Associated Bacterial Pneumonia (VABP) are important for the evaluation of new antimicrobials. However, the heterogeneity in endpoints used in RCTs evaluating treatment of HABP/VABP may puzzle clinicians. The aim of this work was to reach a consensus on clinical endpoints to consider in future clinical trials evaluating antimicrobial treatment efficacy for HABP/VABP. Read More

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http://dx.doi.org/10.1093/cid/ciz093DOI Listing
February 2019
1 Read

Cefiderocol: A Siderophore Cephalosporin with Activity Against Carbapenem-Resistant and Multidrug-Resistant Gram-Negative Bacilli.

Drugs 2019 Feb 2. Epub 2019 Feb 2.

Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

Cefiderocol is an injectable siderophore cephalosporin discovered and being developed by Shionogi & Co., Ltd., Japan. Read More

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http://dx.doi.org/10.1007/s40265-019-1055-2DOI Listing
February 2019
2 Reads

Does lack of thoracic trauma attenuate the severity of pulmonary failure? An 8-year analysis of critically injured patients.

Eur J Trauma Emerg Surg 2019 Feb 2. Epub 2019 Feb 2.

Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave. #225, Memphis, TN, 38163, USA.

Purpose: Patients with thoracic trauma are presumed to be at higher risk for pulmonary dysfunction, but adult respiratory distress syndrome (ARDS) may develop in any patient, regardless of associated chest injury. This study evaluated the impact of thoracic trauma and pulmonary failure on outcomes in trauma patients admitted to the intensive-care unit (ICU).

Methods: All trauma patients admitted to the ICU over an 8-year period were identified. Read More

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http://dx.doi.org/10.1007/s00068-019-01081-wDOI Listing
February 2019
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Investigation of multidrug-resistant ST2 Acinetobacter baumannii isolated from Saint George hospital in Lebanon.

BMC Microbiol 2019 Feb 2;19(1):29. Epub 2019 Feb 2.

Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Faculté de Médecine et de Pharmacie, 19-21 boulevard Jean Moulin, 13385, Marseille, Cedex 05, France.

Background: Acinetobacter baumannii is an opportunistic pathogen causing various nosocomial infections. The spread of multidrug-resistant A. baumannii is a major public health problem. Read More

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http://dx.doi.org/10.1186/s12866-019-1401-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359860PMC
February 2019
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Bacteriologic Profile and Susceptibility Pattern of Mechanically - Ventilated Pediatric Patients with Pneumonia.

J Glob Antimicrob Resist 2019 Jan 30. Epub 2019 Jan 30.

Department of Pediatrics, Alexandria University, Faculty of Medicine, El-Shatby Hospital, Alexandria, Egypt. Electronic address:

Purpose: Therapy of severe pneumonia is very challenging in view of the current widespread bacterial resistance to many antibiotics especially extended spectrum ß-lactams, carbapenems, and anti-pseudomonal drugs. The current study aimed at assessing antimicrobial sensitivity pattern and optimization of the antibiotic stewardship program applied in a university affiliated pediatric intensive care unit (PICU).

Subjects And Methods: This prospective cohort study included all patients aged 1 month to 12 years, admitted to the PICU with severe pneumonia episodes indicated for mechanical ventilation, and were followed up and investigated. Read More

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http://dx.doi.org/10.1016/j.jgar.2019.01.028DOI Listing
January 2019
1 Read

Prevention of Ventilator-Associated Pneumonia in Adults.

Authors:

Crit Care Nurse 2019 Feb;39(1):88

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February 2019
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The most frequent and important events that threaten patient safety in intensive care units from the perspective of health-care professionals'.

J Res Med Sci 2018 28;23:104. Epub 2018 Dec 28.

Department of Health Services Management, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Iran.

Background: Patient safety is a priority in all health-care centers across the world. This study aimed to determine the frequency of events that threaten patient safety and the grade threating of events from the perspective of the health-care professionals in the intensive care units (ICUs).

Materials And Methods: This cross-sectional study was conducted in 2016. Read More

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http://dx.doi.org/10.4103/jrms.JRMS_140_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327678PMC
December 2018
1 Read

Trends and Outcomes for Minimally Invasive Surgery for Inflammatory Bowel Disease.

J Surg Res 2019 Mar 3;235:303-307. Epub 2018 Nov 3.

Department of Surgery, The University of Texas Health Science Center at Houston, Houston, Texas; Department of Surgery, Houston Methodist Hospital, Houston, Texas. Electronic address:

Background: The relapsing and remitting nature of inflammatory bowel disease (IBD) predisposes patients to the development of fibrotic strictures, which must often be managed surgically. Laparoscopy provides the potential for enhanced perioperative care. Previous studies comparing morbidity and trends of open versus laparoscopic resection have been constrained by length of study and sample size. Read More

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http://dx.doi.org/10.1016/j.jss.2018.09.075DOI Listing
March 2019
1 Read

M. pneumoniae and C. pneumoniae are no relevant pathogens in critically ill patients with hospital-acquired respiratory tract infections.

Infection 2019 Jan 28. Epub 2019 Jan 28.

Institute for Infectious Diseases and Infection Control, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.

Purpose: To assess the incidence of Mycoplasma pneumoniae and Chlamydia pneumoniae in the pathogenesis of hospital-acquired respiratory tract infections (RTIs) in critically ill patients.

Methods: This is a retrospective cohort study of all ICU-patients ≥ 18 years with RTI who underwent conventional culture techniques and PCR testing for both M. pneumoniae and C. Read More

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http://dx.doi.org/10.1007/s15010-019-01273-xDOI Listing
January 2019
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A Novel Algorithm to Analyze Epidemiology and Outcomes of Carbapenem Resistance Among Patients With Hospital-acquired and Ventilator-associated Pneumonia: A Retrospective Cohort Study.

Chest 2019 Jan 24. Epub 2019 Jan 24.

Washington Hospital Center, Washington, DC.

Background: Carbapenem resistance is a growing concern. Applying a novel algorithm, we examined epidemiology and outcomes of carbapenem resistance among gram-negative pathogens in hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP).

Methods: In a retrospective cohort design within the Premier Research database (2009-2016), all hospitalized adult patients with a gram-negative organism in a respiratory or blood culture specimen who fit criteria for HAP/VAP based on International Classification of Diseases, Ninth Revision, Clinical Modification, codes were included in the study. Read More

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http://dx.doi.org/10.1016/j.chest.2018.12.024DOI Listing
January 2019
2 Reads

Dependent Functional Status is a Risk Factor for Perioperative and Postoperative Complications After Total Hip Arthroplasty.

J Arthroplasty 2019 Jan 6. Epub 2019 Jan 6.

Department of Orthopaedic Surgery, Detroit Medical Center Detroit, Michigan.

Background: As the population ages, the need for total hip arthroplasty (THA) will increase. However, this will be associated with an increase in comorbidities and a decrease in the ability to independently perform activities of daily living (ADLs). This study was designed to evaluate the impact preoperative functional status has on short-term outcomes after THA. Read More

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http://dx.doi.org/10.1016/j.arth.2018.12.037DOI Listing
January 2019
5 Reads

A Nurse-Driven Oral Care Protocol to Reduce Hospital-Acquired Pneumonia.

Am J Nurs 2019 Feb;119(2):44-51

Chastity Warren is an assistant professor at the Michigan State University College of Nursing and a clinical nurse specialist in critical care at Sparrow Health System, Lansing, MI, where Mary Kathryn Medei and Brooke Wood are RNs in the surgical specialties department. Debra Schutte is an associate professor at the Wayne State University College of Nursing in Detroit and a nurse research consultant in the nursing education and practice department at Sparrow Health System. The following funding sources contributed to the completion of this project: the Sparrow Hospital Department of Nursing Evidence-Based Practice Fellowship Program, Sparrow Foundation Sue Tadgerson Nursing Research Fund, and Delta Dental Foundation, an affiliate of Delta Dental of Michigan, Ohio, and Indiana, which provided an unrestricted educational grant. Contact author: Chastity Warren, The authors have disclosed no potential conflicts of interest, financial or otherwise.

: Purpose: The purpose of this evidence-based quality improvement (QI) project was to implement an oral care protocol in the adult in-patient care areas of a level 1 trauma hospital and to evaluate its impact on the incidence of hospital-acquired pneumonia (HAP).

Methods: A standardized, evidence-based oral care protocol was implemented depending on the level of care required by each ventilated, at-risk, or short-term care patient. The QI project included the introduction of a new suction toothbrush kit for at-risk patients and, for short-term patients, a new short-term oral care kit that featured a more ergonomically appropriate toothbrush, a baking soda toothpaste, and an alcohol-free antiseptic mouthwash; the project also supported the continued use of the then current suction toothbrush kit for patients receiving mechanical ventilation. Read More

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http://dx.doi.org/10.1097/01.NAJ.0000553204.21342.01DOI Listing
February 2019
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The relationship between ventilator-associated pneumonia and chronic obstructive pulmonary disease: what is the current evidence?

Eur J Clin Microbiol Infect Dis 2019 Jan 24. Epub 2019 Jan 24.

Vall d'Hebron Institute of Research (VHIR) & CIBERES, Instituto Salud Carlos III, Barcelona, Spain.

Chronic obstructive pulmonary disease (COPD) affects approximately 65 million people from which > 25% will require intensive care unit (ICU) admission. Ventilator-associated pneumonia (VAP) is the commonest ICU infection and results in increased morbidity/mortality and costs. The literature on the interaction between COPD and VAP is scarce and controversial. Read More

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http://dx.doi.org/10.1007/s10096-019-03486-2DOI Listing
January 2019
2 Reads

Effects of not monitoring gastric residual volume in intensive care patients: A meta-analysis.

Int J Nurs Stud 2019 Jan 3;91:86-93. Epub 2019 Jan 3.

Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China.

Background: Monitoring gastric residual volume has been a common practice in intensive care patients receiving enteral feeding worldwide. Recent studies though, have challenged the reliability and necessity of this routine monitoring process. Several studies even reported improvements in the delivery of enteral feeding without monitoring gastric residual volume, while incurring no additional adverse events. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00207489183026
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http://dx.doi.org/10.1016/j.ijnurstu.2018.11.005DOI Listing
January 2019
5 Reads

Neutrophil Extracellular Traps Are Elevated in Patients with Pneumonia-related Acute Respiratory Distress Syndrome.

Anesthesiology 2019 Jan 22. Epub 2019 Jan 22.

From the Medical Intensive Care Unit, DHU A-TVB, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France (I.B., G.C., K.R., A.M.D., N.d.P.) Groupe de Recherche Clinique CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, Créteil Cedex 94010, France (I.B., G.C., K.R., A.M.D., N.d.P.) Immunology Laboratory « Autoimmunité et Hypersensibilités, » Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France (L.d.C., V.G., S.C.-M.) Pulmonology Unit, Medical Intensive Care Unit, DHU A-TVB, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France (F.S., B.M.) Immunology Laboratory, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France (S.H., M.S., A.B.-F.).

What We Already Know About This Topic: Neutrophil extracellular traps are increasingly recognized as pathogenic in acute injury, but their role in sepsis-related acute respiratory distress syndrome is unknown WHAT THIS ARTICLE TELLS US THAT IS NEW:: In 35 patients with acute respiratory distress syndrome secondary to pneumonia, neutrophil extracellular traps were elevated in the blood and bronchoalveolar fluid, and associated with interleukin-8 and neutrophil levels; however, higher (vs. lower) levels of neutrophil extracellular traps were not associated with mortality or duration of mechanical ventilation BACKGROUND:: Neutrophil extracellular traps have been associated with tissue damage. Whether these are involved in the pathogenesis of human acute respiratory distress syndrome (ARDS) and could be a potential therapeutic target is unknown. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002619DOI Listing
January 2019
5 Reads

Why have trials of inhaled antibiotics for ventilator-associated infections failed?

Authors:
Lucy B Palmer

Curr Opin Infect Dis 2019 Jan 22. Epub 2019 Jan 22.

Pulmonary, Critical Care and Sleep Division, HSC T17-040, SUNY at Stony Brook, New York, USA.

Purpose Of Review: Two recent large randomized placebo-controlled clinical trials of adjunctive inhaled therapy for the treatment of ventilator-associated pneumonia failed to show a mortality effect or more rapid resolution of pneumonia symptoms. Does the failure of these studies to reach their endpoints suggest the end of inhaled therapy? This review will explain why inhaled therapy may still have an important role in the treatment of ventilated patients.

Recent Findings: The recent interest in inhaled antimicrobial therapy is driven by the global emergence of increasingly resistant bacteria to systemic therapy. Read More

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http://dx.doi.org/10.1097/QCO.0000000000000525DOI Listing
January 2019
1 Read

Lung Ultrasound Combined With Procalcitonin for a Diagnosis of Ventilator-Associated Pneumonia.

Respir Care 2019 Jan 22. Epub 2019 Jan 22.

Department of Critical Care Medicine, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo, China.

Background: Lung ultrasound is a valuable imaging tool in the diagnosis of community-acquired pneumonia. However, its diagnostic accuracy in ventilator-associated pneumonia (VAP) has not been fully investigated. The aim of this study was to evaluate the diagnostic performance of the combination of a lung ultrasound with procalcitonin (PCT) in mechanically ventilated subjects with symptoms suggestive of pneumonia. Read More

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http://dx.doi.org/10.4187/respcare.06377DOI Listing
January 2019
2 Reads

Population Pharmacokinetic Analyses for Plazomicin Using Pooled Data from Phase 1, 2, and 3 Clinical Studies.

Antimicrob Agents Chemother 2019 Jan 22. Epub 2019 Jan 22.

Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA.

Plazomicin is an aminoglycoside with activity against multidrug-resistant Enterobacteriaceae. Plazomicin is dosed on a mg/kg basis and administered by 30-min intravenous infusion every 24 h, with dose adjustments for renal impairment and body weight (BW) ≥125% of ideal BW. A population pharmacokinetic analysis was performed to identify patient factors that account for variability in pharmacokinetics and to determine if dose adjustments are warranted based on covariates. Read More

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http://dx.doi.org/10.1128/AAC.02329-18DOI Listing
January 2019
1 Read

Dose Selection and Validation for Ceftazidime-Avibactam in Adults with Complicated Intra-Abdominal Infections, Complicated Urinary Tract Infections and Nosocomial Pneumonia.

Antimicrob Agents Chemother 2019 Jan 22. Epub 2019 Jan 22.

AstraZeneca, Waltham, MA, USA.

Avibactam is a non-β-lactam β-lactamase inhibitor that has been approved in combination with ceftazidime for the treatment of complicated intra-abdominal infections, complicated urinary tract infections and nosocomial pneumonia, including ventilator-associated pneumonia. In Europe, ceftazidime-avibactam is also approved for the treatment of Gram-negative infections with limited treatment options. Selection and validation of the ceftazidime-avibactam dosage regimen was guided by an iterative process of population pharmacokinetic (PK) modelling, whereby population PK models for ceftazidime and avibactam were developed using PK data from clinical trials and updated periodically. Read More

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http://aac.asm.org/lookup/doi/10.1128/AAC.02187-18
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http://dx.doi.org/10.1128/AAC.02187-18DOI Listing
January 2019
3 Reads

A sequential density-based empirical likelihood ratio test for treatment effects.

Stat Med 2019 Jan 20. Epub 2019 Jan 20.

Department of Biostatistics, The State University of New York at Buffalo, Buffalo, New York.

In health-related experiments, treatment effects can be identified using paired data that consist of pre- and posttreatment measurements. In this framework, sequential testing strategies are widely accepted statistical tools in practice. Since performances of parametric sequential testing procedures vitally depend on the validity of the parametric assumptions regarding underlying data distributions, we focus on distribution-free mechanisms for sequentially evaluating treatment effects. Read More

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http://dx.doi.org/10.1002/sim.8095DOI Listing
January 2019
2 Reads

Caloric intake and the fat-to-carbohydrate ratio in hypercapnic acute respiratory failure: Post-hoc analysis of the PermiT trial.

Clin Nutr ESPEN 2019 Feb 13;29:175-182. Epub 2018 Nov 13.

Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address:

Background: The effect of moderate caloric enteral intake in critically ill patients with hypercapnic acute respiratory failure (HCARF) is unclear. We studied the impact of permissive underfeeding (PUF) compared with standard feeding (SF) on various HCARF outcomes.

Materials And Methods: The PermiT trial randomized 894 patients to either PUF (40-60% caloric requirement) or SF (70-100% requirement) with similar protein intake and found no difference in mortality, mechanical ventilation (MV) duration and ventilator-free days. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S24054577183055
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http://dx.doi.org/10.1016/j.clnesp.2018.10.012DOI Listing
February 2019
5 Reads

Tug of war between Acinetobacter baumannii and host immune responses.

Pathog Dis 2018 Dec;76(9)

Department of Immunology and infectious Diseases, John Curtin School of Medical Research, Australian National University, 131 Garran Road, Acton, ACT 2601, Australia.

Acinetobacter baumannii is an emerging nosocomial, opportunistic pathogen with growing clinical significance. Acinetobacter baumannii has an exceptional ability to rapidly develop drug resistance and to adhere to abiotic surfaces, including medical equipment, significantly promoting bacterial spread and also limiting our ability to control A. baumannii infections. Read More

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https://academic.oup.com/femspd/advance-article/doi/10.1093/
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http://dx.doi.org/10.1093/femspd/ftz004DOI Listing
December 2018
3 Reads

Evaluation of Secretion-Clearing Device in Reducing Airway Resistance within Endotracheal Tubes.

Crit Care Res Pract 2018 10;2018:3258396. Epub 2018 Dec 10.

School of Dentistry, West Virginia University, Morgantown, WV, USA.

Background: Secretions accumulate in endotracheal tubes' (ETT) lumens upon their placement in patients. The secretions impact airway resistance and pressure. Secretions potentiate prolonged mechanical ventilation and ventilator-associated pneumonia. Read More

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http://dx.doi.org/10.1155/2018/3258396DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311789PMC
December 2018
2 Reads

Infection-prevention and control interventions to reduce colonisation and infection of intensive care unit-acquired carbapenem-resistant : a 4-year quasi-experimental before-and-after study.

Antimicrob Resist Infect Control 2019 10;8. Epub 2019 Jan 10.

1Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No.197 Ruijin ER Road, Shanghai, 200025 China.

Objective: To determine whether infection-prevention and control (IPC) interventions can reduce the colonisation and infection of intensive care unit (ICU)-acquired carbapenem-resistant (CRKP) in a general ICU ward in China.

Methods: We used a quasi-experimental before-and-after study design. The study was conducted in 4 stages: baseline period, January 2013-June 2013; IPC interventions period including de-escalation and targeted bundle interventions, July 2013-June 2014; modified IPC interventions period, July 2014-June 2015; and follow-up period, July 2015-June 2016. Read More

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https://aricjournal.biomedcentral.com/articles/10.1186/s1375
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http://dx.doi.org/10.1186/s13756-018-0453-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329090PMC
January 2019
6 Reads

Soluble triggering receptor expressed on myeloid cells-1 as a useful biomarker for diagnosing ventilator-associated pneumonia after congenital cardiac surgery in children.

Exp Ther Med 2019 Jan 31;17(1):147-152. Epub 2018 Oct 31.

Department of Infectious Disease, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China.

The present study aimed to assess the usefulness of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in the diagnosis of ventilator-associated pneumonia (VAP) in paediatric patients with congenital heart disease (CHD) following cardiac surgery. The current prospective study enrolled 48 patients with congenital heart diseases who were suspected of having VAP; these patients were undergoing cardiac surgery between August 2016 and October 2017 in the Cardiac Intensive Care Unit of Shanghai Children's Medical Center (Shanghai, China). A total of 31 patients were diagnosed with VAP using a polymerase chain reaction (PCR) assay, while 17 patients without VAP were designated as the Non-VAP group. Read More

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http://dx.doi.org/10.3892/etm.2018.6905DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307413PMC
January 2019
1 Read

Evidence-Based Study Design for Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated Bacterial Pneumonia.

J Infect Dis 2019 Jan 11. Epub 2019 Jan 11.

Foundation for the National Institutes of Health, North Bethesda, Maryland.

Background: The US Food and Drug Administration solicited evidence-based recommendations to improve guidance for studies of hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP).

Methods: We analyzed 7 HABP/VABP datasets to explore novel noninferiority study endpoints and designs, focusing on alternatives to all-cause mortality (ACM).

Results: ACM at day 28 differed for ventilated HABP (27. Read More

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http://dx.doi.org/10.1093/infdis/jiy578DOI Listing
January 2019
2 Reads

Cells under stress: The mechanical environment shapes inflammasome responses to danger signals.

J Leukoc Biol 2019 Jan 15. Epub 2019 Jan 15.

Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.

Many intracellular signals, such as host danger-associated molecules and bacterial toxins during infection, elicit inflammasome activation. However, the mechanical environment in tissues may also influence the sensitivity of various inflammasomes to activation. The cellular mechanical environment is determined by the extracellular tissue stiffness, or its inverse, tissue compliance. Read More

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http://doi.wiley.com/10.1002/JLB.3MIR1118-417R
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http://dx.doi.org/10.1002/JLB.3MIR1118-417RDOI Listing
January 2019
4 Reads

Antimicrobial activity of ceftolozane-tazobactam tested against gram-negative contemporary (2015-2017) isolates from hospitalized patients with pneumonia in US medical centers.

Diagn Microbiol Infect Dis 2018 Nov 30. Epub 2018 Nov 30.

JMI Laboratories, North Liberty, IA 52317.

Pseudomonas aeruginosa (n = 1531) and Enterobacteriaceae (n = 2373) clinical isolates from hospitalized patients with pneumonia were collected from 31 US medical centers during 2015-2017. Isolates were susceptibility tested against ceftolozane-tazobactam and comparators by broth microdilution. Results from intensive care unit (ICU) patients and patients with ventilator-associated bacterial pneumonia (VABP) were analyzed separately. Read More

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http://dx.doi.org/10.1016/j.diagmicrobio.2018.11.021DOI Listing
November 2018
2 Reads

Chest physiotherapy for the prevention of ventilator-associated pneumonia: A meta-analysis.

Am J Infect Control 2019 Jan 11. Epub 2019 Jan 11.

Joint Programme of Nanchang University of London, Nanchang University, Nanchang, Jiangxi, China.

Background: Ventilator-associated pneumonia (VAP) remains a frequent and severe complication in mechanically ventilated patients. We undertook a meta-analysis to evaluate the efficacy of chest physiotherapy (CPT) for the prevention of VAP.

Methods: A systematic literature search of PubMed and Embase databases were searched up until November 25, 2018 for published studies of mechanically ventilated patients comparing CPT with controls and reporting on the occurrence of VAP. Read More

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http://dx.doi.org/10.1016/j.ajic.2018.12.015DOI Listing
January 2019
2 Reads

The Modified 5-Item Frailty Index: A Concise and Useful Tool for Assessing the Impact of Frailty on Postoperative Morbidity Following Elective Posterior Lumbar Fusions.

World Neurosurg 2019 Jan 11. Epub 2019 Jan 11.

Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. Electronic address:

Background: The modified 5-item frailty index (mFI-5) is a concise comorbidity-based risk stratification tool that has been shown to predict the occurrence of adverse outcomes following various orthopedic surgeries.

Methods: The 2012-2016 American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) dataset was used to identify patients undergoing an elective 1- to 2-level posterior lumbar fusion for degenerative lumbar pathology. The mFI-5 score was calculated based on the presence of the 5 co-morbidities: congestive heart failure within 30 days prior to surgery, insulin-dependent or noninsulin-dependent diabetes mellitus, chronic obstructive pulmonary disease or pneumonia, partially dependent or totally dependent functional health status at time of surgery, and hypertension requiring medication. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193003
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http://dx.doi.org/10.1016/j.wneu.2018.12.168DOI Listing
January 2019
7 Reads

Intradermal vaccination with a Pseudomonas aeruginosa vaccine adjuvanted with a mutant bacterial ADP-ribosylating enterotoxin protects against acute pneumonia.

Vaccine 2019 Feb 9;37(6):808-816. Epub 2019 Jan 9.

Department of Microbiology and Immunology, School of Medicine, Tulane University, 1430 Tulane Ave., New Orleans, LA, USA. Electronic address:

Respiratory infections are a leading cause of morbidity and mortality globally. This is partially due to a lack of effective vaccines and a clear understanding of how vaccination route and formulation influence protective immunity in mucosal tissues such as the lung. Pseudomonas aeruginosa is an opportunistic pathogen capable of causing acute pulmonary infections and is a leading cause of hospital-acquired and ventilator-associated pneumonia. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0264410X193000
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http://dx.doi.org/10.1016/j.vaccine.2018.12.053DOI Listing
February 2019
12 Reads

Infant burns: A single institution retrospective review.

Burns 2019 Jan 8. Epub 2019 Jan 8.

Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.

Thermal injuries amongst infants are common and a cause of significant mortality and morbidity in South Africa. This has been attributed to the lack of an enabling environment (poverty-related lack of safe living conditions) and the cognitive and physical developmental immaturity of infants, who depend on their surroundings and adults to keep them safe. This is a retrospective observational study of 548 infant admissions over 48 months. Read More

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http://dx.doi.org/10.1016/j.burns.2018.11.005DOI Listing
January 2019
2 Reads

Polymyxin-resistant Pseudomonas aeruginosa assigned as ST245: First report in an intensive care unit in São Paulo, Brazil.

J Glob Antimicrob Resist 2019 Jan 8;16:147-149. Epub 2019 Jan 8.

Department of Infectious Diseases and LIM-54, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar 470, São Paulo - SP, 05403-000, Brazil.

Objectives: Pseudomonas aeruginosa is a Gram-negative bacterium that causes severe infections, especially in hospitalised and immunocompromised patients. Polymyxins are the last therapeutic option to treat infections caused by this micro-organism. Here we describe a polymyxin-resistant P. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22137165193000
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http://dx.doi.org/10.1016/j.jgar.2018.12.021DOI Listing
January 2019
8 Reads

Awareness among intensive care nurses regarding oral care in critically ill patients.

J Indian Soc Periodontol 2018 Nov-Dec;22(6):541-545

Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, Jagadguru Shri Shivarathreeshwara University, Mysuru, Karnataka, India.

Background: Oral health and general health are interdependent which influence each other through biological, psychological, emotional, and developmental factors. As patients in Intensive Care Unit (ICU) are completely dependent on the caregivers, the knowledge, attitude, and practices of the nurses influence the recovery of patients to a greater extent.

Objectives: Unfortunately, oral health problems are usually overshadowed by other serious needs in critically ill patients. Read More

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http://www.jisponline.com/text.asp?2018/22/6/541/244563
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http://dx.doi.org/10.4103/jisp.jisp_30_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6305093PMC
January 2019
6 Reads

[Clinical characteristics and risk factors of very low birth weight and extremely low birth weight infants with bronchopulmonary dysplasia: multicenter retrospective analysis].

Authors:

Zhonghua Er Ke Za Zhi 2019 Jan;57(1):33-39

To analyze clinical characteristics and risk factors of very low birth weight and extremely low birth weight infants with bronchopulmonary dysplasia (BPD). A retrospective epidemiological study was performed in 768 neonates (376 males) with birth weights<1 500 g and gestational age ≤ 34 weeks who survived ≥28 days. Clinical data were obtained from the multi-center clinical database of neonatal intensive care units (NICU) in 19 hospitals of Jiangsu Province between January 1, 2017 and December 31, 2017. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0578-1310.2019.01.009DOI Listing
January 2019
2 Reads

Ventilatory support after extubation in critically ill patients.

Lancet Respir Med 2018 Dec;6(12):948-962

University Department of Medical, Oral and Biotechnological Sciences, Gabriele d'Annunzio University of Chieti-Pescara, Chieti, Italy; Clinical Department of Anaesthesiology and Intensive Care Medicine, SS. Annunziata Hospital, Chieti, Italy.

The periextubation period represents a crucial moment in the management of critically ill patients. Extubation failure, defined as the need for reintubation within 2-7 days after a planned extubation, is associated with prolonged mechanical ventilation, increased incidence of ventilator-associated pneumonia, longer intensive care unit and hospital stays, and increased mortality. Conventional oxygen therapy is commonly used after extubation. Read More

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http://dx.doi.org/10.1016/S2213-2600(18)30375-8DOI Listing
December 2018
1 Read

Comparison of GeneXpert MRSA/SA ETA assay with semi-quantitative and quantitative cultures and gene-based qPCR for detection of in endotracheal aspirate samples.

Antimicrob Resist Infect Control 2019 5;8. Epub 2019 Jan 5.

1Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, D.S.6.23, 2610 Wilrijk, Belgium.

Introduction: is a common cause of ventilator-associated pneumonia. Rapid and accurate detection of lower respiratory tract colonization and/or infection with may inform targeted preventive and therapeutic strategies. To investigate this, we compared semi-quantitative (SQ)-culture results from 79 endotracheal aspirates (ETA) collected from mechanically-ventilated patients, to two culture and two non-culture-based methods for detection of . Read More

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http://dx.doi.org/10.1186/s13756-018-0460-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6321727PMC
January 2019
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Is a Low Incidence Rate of Ventilation Associated Pneumonia Associated with Lower Mortality? a Descriptive Longitudinal Study in Iran.

Tanaffos 2018 Feb;17(2):110-116

Department of Anesthesiology and Critical Care, Anesthesiology Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Ventilator-Associated Pneumonia (VAP) is an important cause of morbidity and mortality in patients admitted to Intensive Care Unit (ICU). The current study conducted to estimate VAP incidence, attributable mortality and case fatality rate, cost, so related factors can affect the outcome in patients.

Materials And Methods: In this descriptive longitudinal study, demographic, clinical and para-clinical data were collected and attributable mortality and case fatality rate was estimated. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320555PMC
February 2018
2 Reads