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- Annop Piriyapatsom, Hsin Lin, Massimiliano Pirrone, Gennaro De Pascale, Javier Corona De Lapuerta, Edward A Bittner, Ulrich H Schmidt, Marc De Moya, and Lorenzo Berra.
- Department of Anesthesiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
- Respir Care. 2016 Mar 1; 61 (3): 269-76.
BackgroundThe 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.MethodsThis 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.ResultsThe 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.ConclusionsIVAC criteria had a low accuracy for identifying VAP-NHSN in subjects with high-risk trauma.Copyright © 2016 by Daedalus Enterprises.
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