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Respir Care ; 61(3): 269-76, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26556896

RESUMO

BACKGROUND: The Centers for Disease Control and Prevention have recently introduced new ventilator-associated pneumonia (VAP) surveillance on the basis of the infection-related ventilator-associated complication (IVAC) definition. We aim to evaluate the accuracy of this new IVAC algorithm for detecting VAP according to the 2008 Centers for Disease Control and Prevention/National Healthcare Safety Network (NHSN) definition as the reference diagnosis (VAP-NHSN) in high-risk trauma patients. METHODS: This retrospective single-center study included all trauma subjects who were admitted to the ICU, required mechanical ventilation for >48 h, and received a blood transfusion. The new IVAC surveillance and the criteria for VAP-NHSN diagnosis were applied. The accuracy of the new IVAC surveillance for detecting VAP-NHSN was determined, and the clinical outcomes were compared between groups. RESULTS: The sensitivity, specificity, and positive and negative predictive values of IVAC for VAP-NSHN identification were 28.12%, 91.45, 58.06%, and 75.14%, respectively. Subjects with IVAC, VAP-NHSN, or both had higher morbidity when compared with those without IVAC and VAP-NHSN. Subjects with IVAC only had lower morbidity compared with those with VAP-NHSN only or those with both IVAC and VAP-NHSN. There was no significant difference in clinical outcomes between subjects with VAP-NHSN only and those with both IVAC and VAP-NHSN. CONCLUSIONS: IVAC criteria had a low accuracy for identifying VAP-NHSN in subjects with high-risk trauma.


Assuntos
Algoritmos , Controle de Infecções/métodos , Pneumonia Associada à Ventilação Mecânica/diagnóstico , Ferimentos e Lesões/complicações , Adulto , Idoso , Centers for Disease Control and Prevention, U.S. , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Pneumonia Associada à Ventilação Mecânica/etiologia , Valor Preditivo dos Testes , Respiração Artificial/efeitos adversos , Estudos Retrospectivos , Sensibilidade e Especificidade , Estados Unidos/epidemiologia , Ventiladores Mecânicos/efeitos adversos
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