• Pediatr Crit Care Me · Apr 2001

    Frequency of change of ventilator circuit in premature infants: Impact on ventilator-associated pneumonia.

    • Imad R. Makhoul, Imad Kassis, Moshe Berant, Nehama Hashman, Moshe Revach, and Polo Sujov.
    • Departments of Neonatology (Drs. Makhoul and Sujov), Infectious Diseases Unit and Microbiology Laboratory (Drs. Kassis and Hashman), and Pediatrics (Drs. Berant and Revach), Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, Israel. E-mail: request@abim.org
    • Pediatr Crit Care Me. 2001 Apr 1; 2 (2): 127-132.

    ObjectiveVentilator-associated pneumonia (VAP) is associated with substantial mortality. The frequency of changing the ventilator circuit (VC) might influence the occurrence rate of VAP. In premature infants receiving ventilatory support, the question regarding the frequency of changing VC is as yet unsettled. DESIGN: A prospective, randomized, and controlled trial in 60 premature neonates receiving ventilatory support. INTERVENTIONS: We investigated the impact of two VC change regimens on VAP in premature infants, either every 24 hrs or every 72 hrs. In each patient, the humidifier, inspiratory tube, and expiratory tube were changed and cultured at the assigned intervals along with cultures of tracheal aspirates. Blood cultures were obtained whenever there was clinical evidence of pneumonia or sepsis. MEASUREMENTS AND MAIN ResultsThe two study groups did not differ significantly in gestational age, birth weight, gender, duration of mechanical ventilatory support, surfactant therapy, duration of hospitalization, mortality rate, rate of bloodstream infection, or rate of colonization of tracheal aspirate, humidifier, and expiratory tube by microbes. The inspiratory tube was significantly less colonized in the 72-hr group as compared to the 24-hr group (p <.05). The rate of VAP per 1000 ventilator days was not higher in the 72-hr group, compared with the 24-hr group (23.3 vs. 37.7; not significant). Switching from a 24-hr to a 72-hr change policy would save our neonatal intensive care unit a yearly sum of $14,000 (US). ConclusionsExtending the VC-change interval in premature infants from 24 hrs to 72 hrs is safe and cost-effective.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…