• M H Kollef, B Von Harz, D Prentice, S D Shapiro, P Silver, R St John, and E Trovillion.
• Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
• Chest. 1997 Sep 1; 112 (3): 765-73.

Study ObjectiveTo determine whether patient transport out of the ICU is associated with an increased risk of developing ventilator-associated pneumonia.DesignProspective cohort study.SettingICUs of Barnes-Jewish Hospital, a university-affiliated teaching hospital.PatientsFive hundred twenty-one ICU patients requiring mechanical ventilation for > 12 h.InterventionProspective patient surveillance and data collection.Measurements And ResultsThe primary outcome measure was the development of ventilator-associated pneumonia. A total of 273 (52.4%) mechanically ventilated patients required at least one transport out of the ICU while 248 (47.6%) patients did not undergo transport. Sixty-six (24.2%) of the transported patients developed ventilator-associated pneumonia compared with 11 (4.4%) patients in the group not undergoing transport (relative risk=5.5; 95% confidence interval [CI]=2.9 to 10.1; p<0.001). Multiple logistic regression analysis demonstrated that a preceding episode of transport out of the ICU was independently associated with the development of ventilator-associated pneumonia (adjusted odds ratio=3.8; 95% CI=2.6 to 5.5; p<0.001). Other variables independently associated with the development of ventilator-associated pneumonia included reintubation, presence of a tracheostomy, administration of aerosols, and male gender.ConclusionsWe conclude that patient transport out of the ICU is associated with an increased risk for the development of ventilator-associated pneumonia.

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