Ventilator-Associated Events: What They Are and What They Are Not.

Ventilator-Associated Events: What They Are and What They Are Not. Respir Care. 2019 Aug;64(8):953-961 Authors: Klompas M Abstract In 2013, the United States Centers for Disease Control and Prevention redefined surveillance for quality of care in ventilated patients by shifting from ventilator-associated pneumonia (VAP) definitions to ventilator-associated event (VAE) definitions. VAE definitions were designed to overcome many of the limitations of VAP definitions, including their complexity, subjectivity, limited correlation with outcomes, and incomplete capture of many important and morbid complications of mechanical ventilation. VAE definitions broadened the focus of surveillance from pneumonia alone to the syndrome of nosocomial complications in ventilated patients, as marked by sustained increases in ventilator settings after a period of stable or decreasing ventilator settings. Qualitative studies suggest that most VAEs are caused by pneumonia, fluid overload, ARDS, and atelectasis. Only about 40% of clinically diagnosed VAPs meet VAE criteria, likely because the VAE requirement for a sustained increase in ventilator settings sets a threshold effect that selects for patients with severe disease. VAEs are associated with a doubling of the risk of death compared to patients without VAEs and compared to patients who meet traditional VAP criteria. Risk factors for VAEs include sedation with benzodiazepines or propofol, volume overl...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Respir Care Source Type: research