One-week versus 2-day ventilator circuit change in neonates with prolonged ventilation: cost-effectiveness and impact on ventilator-associated pneumonia.

Abstract:

OBJECTIVE:To investigate the impact of 1-week ventilator circuit change on ventilator-associated pneumonia and its cost-effectiveness compared with a 2-day change. DESIGN:An observational cohort study. SETTING:A tertiary level neonatal intensive care unit in a university-affiliated teaching hospital in Taiwan. Patients All neonates in the neonatal intensive care unit receiving invasive intubation for more than 1 week from July 1, 2011, through December 31, 2013. INTERVENTION:We investigated the impact of 2 ventilator circuit change regimens, either every 2 days or 7 days, on ventilator-associated pneumonia of our cohort. MEASUREMENTS AND MAIN RESULTS:A total of 361 patients were maintained on mechanical ventilators for 13,981 days. The 2 groups did not differ significantly in any demographic characteristics. The rate of ventilator-associated pneumonia was comparable between the 2-day group and the 7-day group (8.2 vs 9.5 per 1,000 ventilator-days, P=.439). The durations of mechanical ventilation and hospital stay, and rates of bloodstream infection and mortality, were also comparable between the 2 groups. Switching from a 2-day to a 7-day change policy would save our neonatal intensive care unit a yearly sum of US $29,350 and 525 working hours. CONCLUSION:Decreasing the frequency of ventilator circuit changes from every 2 days to once per week is safe and cost-effective in neonates requiring prolonged intubation for more than 1 week.

authors

Chu SM,Yang MC,Hsiao HF,Hsu JF,Lien R,Chiang MC,Fu RH,Huang HR,Hsu KH,Tsai MH

doi

10.1017/ice.2014.48

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

287-93

issue

3

eissn

0899-823X

issn

1559-6834

pii

S0899823X14000488

journal_volume

36

pub_type

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