A Pediatric Approach to Ventilator-Associated Events Surveillance
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retr...
Gespeichert in:
| Veröffentlicht in: | Infection control and hospital epidemiology 2017-03, Vol.38 (3), p.327-333 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 333 |
|---|---|
| container_issue | 3 |
| container_start_page | 327 |
| container_title | Infection control and hospital epidemiology |
| container_volume | 38 |
| creator | Cocoros, Noelle M Priebe, Gregory P Logan, Latania K Coffin, Susan Larsen, Gitte Toltzis, Philip Sandora, Thomas J Harper, Marvin Sammons, Julia S Gray, James E Goldmann, Donald Horan, Kelly Burton, Michael Checchia, Paul A Lakoma, Matthew Sims, Shannon Klompas, Michael Lee, Grace M |
| description | OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria. We applied adult temperature, white blood cell count, antibiotic, and culture criteria for IVAC and PVAP to these patients. We matched pediatric VAC patients with controls and evaluated associations with adverse outcomes using Cox proportional hazards models. RESULTS In total, 233 pediatric VACs (12,167 ventilation episodes) were identified. In the cardiac ICU (CICU), 62.5% of VACs met adult IVAC criteria; in the pediatric ICU (PICU), 54.2% of VACs met adult IVAC criteria; and in the neonatal ICU (NICU), 20.2% of VACs met adult IVAC criteria. Most patients had abnormal white blood cell counts and temperatures; we therefore recommend simplifying surveillance by focusing on "pediatric VAC with antimicrobial use" (pediatric AVAC). Pediatric AVAC with a positive respiratory diagnostic test ("pediatric PVAP") occurred in 8.9% of VACs in the CICU, 13.3% of VACs in the PICU, and 4.3% of VACs in the NICU. Hospital mortality was increased, and hospital and ICU length of stay and duration of ventilation were prolonged among all pediatric VAE subsets compared with controls. CONCLUSIONS We propose pediatric AVAC for surveillance related to antimicrobial use, with pediatric PVAP as a subset of AVAC. Studies on generalizability and responsiveness of these metrics to quality improvement initiatives are needed, as are studies to determine whether lower pediatric VAE rates are associated with improvements in other outcomes. Infect Control Hosp Epidemiol 2017;38:327-333. |
| doi_str_mv | 10.1017/ice.2016.277 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1846024366</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1846024366</sourcerecordid><originalsourceid>FETCH-LOGICAL-c319t-e6db37baebe036061136b05e49151b45666861af7273b592072d8149ee380a3e3</originalsourceid><addsrcrecordid>eNpdkEtLAzEURoMotlZ3rmXAjQun5iaZPJZDqQ8oKPjAXchkbnFK26nJTMF_b0rVhasLl8PH4RByDnQMFNRN43HMKMgxU-qADKEoTC41F4dkSLUxuWb8fUBOYlxQSpUxcEwGTBlQiqshKcvsCevGdaHxWbnZhNb5j6xrszdcd83SdW3IyxhbnxCss-k2vWP23IctNsulW3s8JUdzt4x49nNH5PV2-jK5z2ePdw-TcpZ7DqbLUdYVV5XDCimXVAJwWdEChYECKlFIKbUEN1dM8aowjCpWaxAGkWvqOPIRudrvJsfPHmNnV030uJPAto8WtJCUCS5lQi__oYu2D-tkZ5kWQinQYBJ1vad8aGMMOLeb0Kxc-LJA7S6tTWntLq1NaRN-8TPaVyus_-DflvwbqfRyHg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2844771819</pqid></control><display><type>article</type><title>A Pediatric Approach to Ventilator-Associated Events Surveillance</title><source>MEDLINE</source><source>Cambridge Journals</source><source>ProQuest Central</source><creator>Cocoros, Noelle M ; Priebe, Gregory P ; Logan, Latania K ; Coffin, Susan ; Larsen, Gitte ; Toltzis, Philip ; Sandora, Thomas J ; Harper, Marvin ; Sammons, Julia S ; Gray, James E ; Goldmann, Donald ; Horan, Kelly ; Burton, Michael ; Checchia, Paul A ; Lakoma, Matthew ; Sims, Shannon ; Klompas, Michael ; Lee, Grace M</creator><creatorcontrib>Cocoros, Noelle M ; Priebe, Gregory P ; Logan, Latania K ; Coffin, Susan ; Larsen, Gitte ; Toltzis, Philip ; Sandora, Thomas J ; Harper, Marvin ; Sammons, Julia S ; Gray, James E ; Goldmann, Donald ; Horan, Kelly ; Burton, Michael ; Checchia, Paul A ; Lakoma, Matthew ; Sims, Shannon ; Klompas, Michael ; Lee, Grace M</creatorcontrib><description>OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria. We applied adult temperature, white blood cell count, antibiotic, and culture criteria for IVAC and PVAP to these patients. We matched pediatric VAC patients with controls and evaluated associations with adverse outcomes using Cox proportional hazards models. RESULTS In total, 233 pediatric VACs (12,167 ventilation episodes) were identified. In the cardiac ICU (CICU), 62.5% of VACs met adult IVAC criteria; in the pediatric ICU (PICU), 54.2% of VACs met adult IVAC criteria; and in the neonatal ICU (NICU), 20.2% of VACs met adult IVAC criteria. Most patients had abnormal white blood cell counts and temperatures; we therefore recommend simplifying surveillance by focusing on "pediatric VAC with antimicrobial use" (pediatric AVAC). Pediatric AVAC with a positive respiratory diagnostic test ("pediatric PVAP") occurred in 8.9% of VACs in the CICU, 13.3% of VACs in the PICU, and 4.3% of VACs in the NICU. Hospital mortality was increased, and hospital and ICU length of stay and duration of ventilation were prolonged among all pediatric VAE subsets compared with controls. CONCLUSIONS We propose pediatric AVAC for surveillance related to antimicrobial use, with pediatric PVAP as a subset of AVAC. Studies on generalizability and responsiveness of these metrics to quality improvement initiatives are needed, as are studies to determine whether lower pediatric VAE rates are associated with improvements in other outcomes. Infect Control Hosp Epidemiol 2017;38:327-333.</description><identifier>ISSN: 0899-823X</identifier><identifier>EISSN: 1559-6834</identifier><identifier>DOI: 10.1017/ice.2016.277</identifier><identifier>PMID: 27917737</identifier><language>eng</language><publisher>United States: Cambridge University Press</publisher><subject>Adolescent ; Anti-Bacterial Agents - therapeutic use ; Child ; Child, Preschool ; Diagnostic tests ; Disease control ; Female ; Hospital Mortality - trends ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Infections ; Intensive care ; Intensive Care Units - classification ; Intensive Care Units - statistics & numerical data ; Length of Stay - statistics & numerical data ; Male ; Mortality ; Nursing ; Patients ; Pediatrics ; Pneumonia ; Pneumonia, Ventilator-Associated - diagnosis ; Pneumonia, Ventilator-Associated - drug therapy ; Proportional Hazards Models ; Respiration, Artificial - adverse effects ; Retrospective Studies ; Surveillance ; Temperature ; United States - epidemiology ; Ventilation ; Ventilators ; Working groups</subject><ispartof>Infection control and hospital epidemiology, 2017-03, Vol.38 (3), p.327-333</ispartof><rights>2016 by The Society for Healthcare Epidemiology of America. All rights reserved</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c319t-e6db37baebe036061136b05e49151b45666861af7273b592072d8149ee380a3e3</citedby><cites>FETCH-LOGICAL-c319t-e6db37baebe036061136b05e49151b45666861af7273b592072d8149ee380a3e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2844771819/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2844771819?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,21367,27901,27902,33721,33722,43781,74045</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27917737$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cocoros, Noelle M</creatorcontrib><creatorcontrib>Priebe, Gregory P</creatorcontrib><creatorcontrib>Logan, Latania K</creatorcontrib><creatorcontrib>Coffin, Susan</creatorcontrib><creatorcontrib>Larsen, Gitte</creatorcontrib><creatorcontrib>Toltzis, Philip</creatorcontrib><creatorcontrib>Sandora, Thomas J</creatorcontrib><creatorcontrib>Harper, Marvin</creatorcontrib><creatorcontrib>Sammons, Julia S</creatorcontrib><creatorcontrib>Gray, James E</creatorcontrib><creatorcontrib>Goldmann, Donald</creatorcontrib><creatorcontrib>Horan, Kelly</creatorcontrib><creatorcontrib>Burton, Michael</creatorcontrib><creatorcontrib>Checchia, Paul A</creatorcontrib><creatorcontrib>Lakoma, Matthew</creatorcontrib><creatorcontrib>Sims, Shannon</creatorcontrib><creatorcontrib>Klompas, Michael</creatorcontrib><creatorcontrib>Lee, Grace M</creatorcontrib><title>A Pediatric Approach to Ventilator-Associated Events Surveillance</title><title>Infection control and hospital epidemiology</title><addtitle>Infect Control Hosp Epidemiol</addtitle><description>OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria. We applied adult temperature, white blood cell count, antibiotic, and culture criteria for IVAC and PVAP to these patients. We matched pediatric VAC patients with controls and evaluated associations with adverse outcomes using Cox proportional hazards models. RESULTS In total, 233 pediatric VACs (12,167 ventilation episodes) were identified. In the cardiac ICU (CICU), 62.5% of VACs met adult IVAC criteria; in the pediatric ICU (PICU), 54.2% of VACs met adult IVAC criteria; and in the neonatal ICU (NICU), 20.2% of VACs met adult IVAC criteria. Most patients had abnormal white blood cell counts and temperatures; we therefore recommend simplifying surveillance by focusing on "pediatric VAC with antimicrobial use" (pediatric AVAC). Pediatric AVAC with a positive respiratory diagnostic test ("pediatric PVAP") occurred in 8.9% of VACs in the CICU, 13.3% of VACs in the PICU, and 4.3% of VACs in the NICU. Hospital mortality was increased, and hospital and ICU length of stay and duration of ventilation were prolonged among all pediatric VAE subsets compared with controls. CONCLUSIONS We propose pediatric AVAC for surveillance related to antimicrobial use, with pediatric PVAP as a subset of AVAC. Studies on generalizability and responsiveness of these metrics to quality improvement initiatives are needed, as are studies to determine whether lower pediatric VAE rates are associated with improvements in other outcomes. Infect Control Hosp Epidemiol 2017;38:327-333.</description><subject>Adolescent</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Diagnostic tests</subject><subject>Disease control</subject><subject>Female</subject><subject>Hospital Mortality - trends</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Intensive Care Units - classification</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Mortality</subject><subject>Nursing</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pneumonia</subject><subject>Pneumonia, Ventilator-Associated - diagnosis</subject><subject>Pneumonia, Ventilator-Associated - drug therapy</subject><subject>Proportional Hazards Models</subject><subject>Respiration, Artificial - adverse effects</subject><subject>Retrospective Studies</subject><subject>Surveillance</subject><subject>Temperature</subject><subject>United States - epidemiology</subject><subject>Ventilation</subject><subject>Ventilators</subject><subject>Working groups</subject><issn>0899-823X</issn><issn>1559-6834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkEtLAzEURoMotlZ3rmXAjQun5iaZPJZDqQ8oKPjAXchkbnFK26nJTMF_b0rVhasLl8PH4RByDnQMFNRN43HMKMgxU-qADKEoTC41F4dkSLUxuWb8fUBOYlxQSpUxcEwGTBlQiqshKcvsCevGdaHxWbnZhNb5j6xrszdcd83SdW3IyxhbnxCss-k2vWP23IctNsulW3s8JUdzt4x49nNH5PV2-jK5z2ePdw-TcpZ7DqbLUdYVV5XDCimXVAJwWdEChYECKlFIKbUEN1dM8aowjCpWaxAGkWvqOPIRudrvJsfPHmNnV030uJPAto8WtJCUCS5lQi__oYu2D-tkZ5kWQinQYBJ1vad8aGMMOLeb0Kxc-LJA7S6tTWntLq1NaRN-8TPaVyus_-DflvwbqfRyHg</recordid><startdate>201703</startdate><enddate>201703</enddate><creator>Cocoros, Noelle M</creator><creator>Priebe, Gregory P</creator><creator>Logan, Latania K</creator><creator>Coffin, Susan</creator><creator>Larsen, Gitte</creator><creator>Toltzis, Philip</creator><creator>Sandora, Thomas J</creator><creator>Harper, Marvin</creator><creator>Sammons, Julia S</creator><creator>Gray, James E</creator><creator>Goldmann, Donald</creator><creator>Horan, Kelly</creator><creator>Burton, Michael</creator><creator>Checchia, Paul A</creator><creator>Lakoma, Matthew</creator><creator>Sims, Shannon</creator><creator>Klompas, Michael</creator><creator>Lee, Grace M</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201703</creationdate><title>A Pediatric Approach to Ventilator-Associated Events Surveillance</title><author>Cocoros, Noelle M ; Priebe, Gregory P ; Logan, Latania K ; Coffin, Susan ; Larsen, Gitte ; Toltzis, Philip ; Sandora, Thomas J ; Harper, Marvin ; Sammons, Julia S ; Gray, James E ; Goldmann, Donald ; Horan, Kelly ; Burton, Michael ; Checchia, Paul A ; Lakoma, Matthew ; Sims, Shannon ; Klompas, Michael ; Lee, Grace M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c319t-e6db37baebe036061136b05e49151b45666861af7273b592072d8149ee380a3e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Diagnostic tests</topic><topic>Disease control</topic><topic>Female</topic><topic>Hospital Mortality - trends</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Intensive Care Units - classification</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Mortality</topic><topic>Nursing</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Pneumonia</topic><topic>Pneumonia, Ventilator-Associated - diagnosis</topic><topic>Pneumonia, Ventilator-Associated - drug therapy</topic><topic>Proportional Hazards Models</topic><topic>Respiration, Artificial - adverse effects</topic><topic>Retrospective Studies</topic><topic>Surveillance</topic><topic>Temperature</topic><topic>United States - epidemiology</topic><topic>Ventilation</topic><topic>Ventilators</topic><topic>Working groups</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cocoros, Noelle M</creatorcontrib><creatorcontrib>Priebe, Gregory P</creatorcontrib><creatorcontrib>Logan, Latania K</creatorcontrib><creatorcontrib>Coffin, Susan</creatorcontrib><creatorcontrib>Larsen, Gitte</creatorcontrib><creatorcontrib>Toltzis, Philip</creatorcontrib><creatorcontrib>Sandora, Thomas J</creatorcontrib><creatorcontrib>Harper, Marvin</creatorcontrib><creatorcontrib>Sammons, Julia S</creatorcontrib><creatorcontrib>Gray, James E</creatorcontrib><creatorcontrib>Goldmann, Donald</creatorcontrib><creatorcontrib>Horan, Kelly</creatorcontrib><creatorcontrib>Burton, Michael</creatorcontrib><creatorcontrib>Checchia, Paul A</creatorcontrib><creatorcontrib>Lakoma, Matthew</creatorcontrib><creatorcontrib>Sims, Shannon</creatorcontrib><creatorcontrib>Klompas, Michael</creatorcontrib><creatorcontrib>Lee, Grace M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Infection control and hospital epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cocoros, Noelle M</au><au>Priebe, Gregory P</au><au>Logan, Latania K</au><au>Coffin, Susan</au><au>Larsen, Gitte</au><au>Toltzis, Philip</au><au>Sandora, Thomas J</au><au>Harper, Marvin</au><au>Sammons, Julia S</au><au>Gray, James E</au><au>Goldmann, Donald</au><au>Horan, Kelly</au><au>Burton, Michael</au><au>Checchia, Paul A</au><au>Lakoma, Matthew</au><au>Sims, Shannon</au><au>Klompas, Michael</au><au>Lee, Grace M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Pediatric Approach to Ventilator-Associated Events Surveillance</atitle><jtitle>Infection control and hospital epidemiology</jtitle><addtitle>Infect Control Hosp Epidemiol</addtitle><date>2017-03</date><risdate>2017</risdate><volume>38</volume><issue>3</issue><spage>327</spage><epage>333</epage><pages>327-333</pages><issn>0899-823X</issn><eissn>1559-6834</eissn><abstract>OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria. We applied adult temperature, white blood cell count, antibiotic, and culture criteria for IVAC and PVAP to these patients. We matched pediatric VAC patients with controls and evaluated associations with adverse outcomes using Cox proportional hazards models. RESULTS In total, 233 pediatric VACs (12,167 ventilation episodes) were identified. In the cardiac ICU (CICU), 62.5% of VACs met adult IVAC criteria; in the pediatric ICU (PICU), 54.2% of VACs met adult IVAC criteria; and in the neonatal ICU (NICU), 20.2% of VACs met adult IVAC criteria. Most patients had abnormal white blood cell counts and temperatures; we therefore recommend simplifying surveillance by focusing on "pediatric VAC with antimicrobial use" (pediatric AVAC). Pediatric AVAC with a positive respiratory diagnostic test ("pediatric PVAP") occurred in 8.9% of VACs in the CICU, 13.3% of VACs in the PICU, and 4.3% of VACs in the NICU. Hospital mortality was increased, and hospital and ICU length of stay and duration of ventilation were prolonged among all pediatric VAE subsets compared with controls. CONCLUSIONS We propose pediatric AVAC for surveillance related to antimicrobial use, with pediatric PVAP as a subset of AVAC. Studies on generalizability and responsiveness of these metrics to quality improvement initiatives are needed, as are studies to determine whether lower pediatric VAE rates are associated with improvements in other outcomes. Infect Control Hosp Epidemiol 2017;38:327-333.</abstract><cop>United States</cop><pub>Cambridge University Press</pub><pmid>27917737</pmid><doi>10.1017/ice.2016.277</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0899-823X |
| ispartof | Infection control and hospital epidemiology, 2017-03, Vol.38 (3), p.327-333 |
| issn | 0899-823X 1559-6834 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1846024366 |
| source | MEDLINE; Cambridge Journals; ProQuest Central |
| subjects | Adolescent Anti-Bacterial Agents - therapeutic use Child Child, Preschool Diagnostic tests Disease control Female Hospital Mortality - trends Hospitals Humans Infant Infant, Newborn Infections Intensive care Intensive Care Units - classification Intensive Care Units - statistics & numerical data Length of Stay - statistics & numerical data Male Mortality Nursing Patients Pediatrics Pneumonia Pneumonia, Ventilator-Associated - diagnosis Pneumonia, Ventilator-Associated - drug therapy Proportional Hazards Models Respiration, Artificial - adverse effects Retrospective Studies Surveillance Temperature United States - epidemiology Ventilation Ventilators Working groups |
| title | A Pediatric Approach to Ventilator-Associated Events Surveillance |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T06%3A23%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Pediatric%20Approach%20to%20Ventilator-Associated%20Events%20Surveillance&rft.jtitle=Infection%20control%20and%20hospital%20epidemiology&rft.au=Cocoros,%20Noelle%20M&rft.date=2017-03&rft.volume=38&rft.issue=3&rft.spage=327&rft.epage=333&rft.pages=327-333&rft.issn=0899-823X&rft.eissn=1559-6834&rft_id=info:doi/10.1017/ice.2016.277&rft_dat=%3Cproquest_cross%3E1846024366%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2844771819&rft_id=info:pmid/27917737&rfr_iscdi=true |