Prevalence, Clinical Characteristics, and Outcomes Related to Ventilator-Associated Events in Neurocritically Ill Patients
| Autor: | Abhijit V. Lele, Venus Kit Sze Wu, Andrew M. Walters, Christine Fong |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Outcomes Critical Care and Intensive Care Medicine law.invention 03 medical and health sciences 0302 clinical medicine Mechanical ventilation law Neurocritical care Prevalence Medicine Humans Stroke Retrospective Studies Ventilator-associated event Ventilators Mechanical business.industry Glasgow Coma Scale Neurointensive care Pneumonia Ventilator-Associated 030208 emergency & critical care medicine Retrospective cohort study medicine.disease Intensive care unit Respiration Artificial Pneumonia Intensive Care Units VAE Emergency medicine Breathing Neurology (clinical) business 030217 neurology & neurosurgery Original Work |
| Zdroj: | Neurocritical Care |
| ISSN: | 1556-0961 1541-6933 |
| Popis: | Background The prevalence, characteristics, and outcomes related to the ventilator-associated event(s) (VAE) in neurocritically ill patients are unknown and examined in this study. Methods A retrospective study was performed on neurocritically ill patients at a 413-bed level 1 trauma and stroke center who received three or more days of mechanical ventilation to describe rates of VAE, describe characteristics of patients with VAE, and examine the association of VAE on ventilator days, mortality, length of stay, and discharge to home. Results Over a 5-year period from 2014 through 2018, 855 neurocritically ill patients requiring mechanical ventilation were identified. A total of 147 VAEs occurred in 130 (15.2%) patients with an overall VAE rate of 13 per 1000 ventilator days and occurred across age, sex, BMI, and admission Glasgow Coma Scores. The average time from the start of ventilation to a VAE was 5 (range 3–48) days after initiation of mechanical ventilation. Using Centers for Disease Control and Prevention definitions, VAEs met criteria for a ventilator-associated condition in 58% of events (n = 85), infection-related VAE in 22% of events (n = 33), and possible ventilator-associated pneumonia in 20% of events (n = 29). A most common trigger for VAE was an increase in positive end-expiratory pressure (84%). Presence of a VAE was associated with an increase in duration of mechanical ventilation (17.4[IQR 20.5] vs. 7.9[8.9] days, p |
| Databáze: | OpenAIRE |
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