• Nicholas M Mohr, Karisa K Harland, Dionne Skeete, Kent Pearson, and Kent Choi.
• Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA; Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine, Iowa City, IA. Electronic address: nicholas-mohr@uiowa.edu.
• J Crit Care. 2014 Aug 1;29(4):539-44.

PurposeVentilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality among critically ill patients with trauma. Few VAP prevention strategies have been studied in the prehospital environment. The objectives of this study are to measure the association between duration of prehospital intubation and intubation location with subsequent incidence of early (within 5 days) VAP.Materials And MethodsSingle-center retrospective cohort study of all intubated adult (age≥18 years) patients with trauma presenting to a 711-bed Midwestern Level I trauma center between January 2005 and December 2011 (n=860).ResultsThirty-five patients (6.4%) were diagnosed as having early VAP during the study period. Using multivariable logistic regression to adjust for age, injury severity score, and year (corresponding to VAP bundle implementation), the duration of intubation prior to hospital admission was not associated with subsequent diagnosis of VAP (adjusted odds ratio, 0.90 per hour; 95% confidence interval, 0.70-1.15). Location of intubation was similarly not associated with VAP.ConclusionsDuration of prehospital intubation and intubation location were not different in patients with trauma who developed early VAP. Further prospective analyses should be conducted to better elucidate the effect of prehospital management on the development of traditionally in-hospital complications.Copyright © 2014 Elsevier Inc. All rights reserved.

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