المؤلفون: Han JN; Respiratory Care Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. janet_han2000@hotmail.com, Liu YP, Ma S, Zhu YJ, Sui SH, Chen XJ, Luo DM, Adams AB, Marini JJ

المصدر: Respiratory care [Respir Care] 2001 Sep; Vol. 46 (9), pp. 891-6.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Daedalus Enterprises for the American Association for Respiratory Therapy Country of Publication: United States NLM ID: 7510357 Publication Model: Print Cited Medium: Print ISSN: 0020-1324 (Print) Linking ISSN: 00201324 NLM ISO Abbreviation: Respir Care Subsets: MEDLINE

مواضيع طبية MeSH: Ventilators, Mechanical*, Cross Infection/*prevention & control , Pneumonia/*prevention & control , Respiration, Artificial/*instrumentation, Cross Infection/etiology ; Cross Infection/mortality ; Female ; Humans ; Male ; Middle Aged ; Pneumonia/etiology ; Pneumonia/mortality ; Respiration, Artificial/adverse effects ; Seasons

مستخلص: Introduction: We investigated whether decreasing ventilator circuit changes from every 2 days to every 7 days would impact ventilator-associated pneumonia rates at our institution.
Methods: All mechanically ventilated patients at Peking Union Medical College Hospital were studied over a 21 month period. From March 1998 to February 1999, ventilator circuits were changed every 2 days, and from June through December 1999, ventilator circuits were changed every 7 days. Nosocomial pneumonia was identified using the criteria of the Centers for Disease Control.
Results: In the 2-day-change group, there were 2,277 ventilator-patient days and 38 patients developed pneumonia, resulting in a pneumonia rate of 16.7 cases per 1,000 ventilator days. The 7-day-change group accumulated 972 ventilator days and 8 patients contracted pneumonia, resulting in a pneumonia rate of 8.2 cases per 1,000 ventilator days. The pneumonia rate was significantly lower in the 7-day-change group (p = 0.007). To standardize for seasonal variability, we compared results from the same seasonal time frames (June to December 1998 for the 2-day-change group, and June to December 1999 for the 7-day-change group), and obtained similar findings: during those periods, pneumonia rates were 24.2 cases per 1,000 ventilator days for the 2-day-change group and 8.9 cases per 1,000 ventilator days for the 7-day-change group (p = 0.001).
Conclusions: A circuit change interval of 7 days had a lower risk of ventilator-associated pneumonia than a 2-day change interval. Therefore, ventilator circuits can be safely changed every 7 days in our setting.