Incidence of ventilator associated events among intubated patients in neurosurgery ICU of a tertiary health centre in India

Thomas, Andrew; Jitendranath, Ashish; Vishwamohanan, Ivy; Bhai, Geetha; Sarika, .

doi:10.18231/j.ijmr.2019.032

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…In this study, the overall VAE incidence and rate occurred as 16.6% and 17.1/1000 ventilator days, respectively. Our VAE rate was found to be lower than that of other studies conducted in India by Vaisakh et al, 7 Thomas et al 8 and Sharma et al 9 reporting VAE rates of 29.2%, 29.6% and 19.5% respectively. A study in India has reported the rates of the subtypes of VAE, 27% cases were VAC only (6.7/1000 ventilator days), 48.6% were IVAC (11.5/1000 ventilator days), and 24% were PVAP (5.7/1000 ventilator days) whereas a it was reported as 6.4/1000 ventilator days, which is quite low as compared to that of our study.…”

Section: Discussioncontrasting

confidence: 77%

“…A study in India has reported the rates of the subtypes of VAE, 27% cases were VAC only (6.7/1000 ventilator days), 48.6% were IVAC (11.5/1000 ventilator days), and 24% were PVAP (5.7/1000 ventilator days) whereas a it was reported as 6.4/1000 ventilator days, which is quite low as compared to that of our study. 10 Vaisakh et al 7 reported 58.3% VACs, 25% IVACs, and 8.3% PVAP. Our study encountered more cases of PVAP as compared to their study.…”

Section: Discussionmentioning

confidence: 99%

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Ventilator associated events:incidence, microbiological profile and outcome in the intensive care unit in a tertiary hospital of eastern Nepal

Jha¹,

Khanal²,

Sah³

et al. 2023

IJMR

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Ventilator associated events (VAE) refer to new surveillance definition developed by Centre for Disease Control and prevention (CDC)/ National Healthcare Safety Network (NHSN) is in use since the year 2013, switching the focus of surveillance from ventilator associated pneumonia (VAP) to ventilator associated events (VAE). A number of studies have been conducted in the United States and other Western countries to evaluate its practicality. However, information on VAE in Asian countries is scarce. The purpose of this preliminary study was to illuminate the incidence and microbiological profile of VAEs in tertiary hospital in Nepal, as a first step in the effort to determine its practicality.The objective of the study was to determine the incidence, etiological agent and mortality of VAE in patients on mechanical ventilation in medical Intensive care unit (ICU) of a tertiary hospital. Patients admitted in ICU on Mechanical Ventilation were evaluated daily using the VAE surveillance criteria. At least 2 days of stable or decreasing ventilator settings followed by at least 2 days of increased ventilator settings was used as definition of VAE. Three tiered approach of VAE, namely Ventilator-Associated Condition (VAC), Infection-related Ventilator-Associated Complication (IVAC) and Possible VAP (PVAP) was used for the final classification of cases. Of the 313 patients admitted to the ICU over the period of one year, 52 patients received MV for ≥2 days and met baseline criteria for VAEs Surveillance. Out of 52 patients, 14(27%) developed VAC only, 13(25%) developed IVAC only and 25(48%) patients developed PVAP. Endotracheal aspirate culture was positive in 25 patients (48%). The organisms isolated 14(53.84%), 7(26.92%), 4(15.38%), and 1(3.84%). Polymicrobial growth was observed in one Almost all the isolates 25 (96%) being multidrug resistant. Overall mortality rate in patients with VAE was 36.5% with highest mortality rate in PVAP (44%). Early onset PVAP was observed in 9 (36%) where as 16 (64%) had late‑ onset VAP.VAE mostly being health care associated event and prevalence of multidrug resistance in as observed in this study warrant clinician to practices infection control measures and rationale use of antimicrobials as effective measures for infection control.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Ventilator associated events:incidence, microbiological profile and outcome in the intensive care unit in a tertiary hospital of eastern Nepal

Jha¹,

Khanal²,

Sah³

et al. 2023

IJMR

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“…The incidence of VAE in present study was 6.4%, which is much lesser then the studies conducted by Sharma et al and Thomas A et al where VAE incidence was 19.5% and 15.1% respectively ( 8 , 9 ). Possibly, the higher incidence is due to a lower number of patients enrolled, which is found similar to the research conducted by Thomas A et al where the occurrence of VAE was elevated among males compared to females, specifically at a rate of 80%, aligning with the findings of the present study with 82% male patients ( 9 ).…”

Section: Discussioncontrasting

confidence: 68%

Prevalence of ventilator-associated events and antibiogram of bacterial isolates of ventilator-associated pneumonia in a tertiary care hospital of Uttarakhand

Kori,

Negi,

Chandola

et al. 2023

IJM

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Background and Objectives: Despite progress in diagnosing and managing ventilator-associated pneumonia (VAP), ongo- ing monitoring of ventilator-associated events (VAE) is crucial due to VAP's persistent prominence as the primary cause of Hospital-Acquired Infection (HAI) among Intensive Care unit patients. This study was done to illuminate the prevalence of VAE and antibiogram of bacterial isolates of VAP in a tertiary care hospital of Uttarakhand. Materials and Methods: This cross-sectional study focused on ICU patients. Adult patients ventilated for > 2 days were monitored daily, with VAE data analyzed using Center of Disease Control & Prevention (CDC) criteria. Specimens were sent to the Microbiology Department and cultured on Blood agar and MacConkey agar. Identification and antimicrobial profiles of isolates were determined using Vitek-2 Compact. Results: 1220 ventilated individuals were assessed in total. VAE was diagnosed in 6.4% (78/1220) of the patients, the same later developed ventilator associated condition (VAC), 74 developed the infection-related VAC (IVAC), and 60 developed the possible/probable VAP (PVAP) among the 78 VAE cases. Klebsiella pneumoniae (35%), Acinetobacter baumannii (33%), and Pseudomonas aeruginosa (16%) were the most common isolated organisms. Colistin (57%) was the most effective against Klebsiella pneumoniae, followed by amikacin (28.5%) and trimethoprim+sulfamethoxazole (24%). Pseudomonas aeruginosa was most susceptible to imipenem (70%), meropenem, cefoperazone+sulbactam, and colistin (60%). Acineto- bacter baumannii was most susceptible to colistin (85%), tigecycline (65%), and trimethoprim+sulfamethoxazole (25%). Conclusion: The most common cause of HAI is VAP. The purpose of this study is to determine the importance of starting suitable antibiotics early for prognosis and the difficulty of diagnosing VAP.

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Comparative Study of Demographic Profile, Mortality, Risk Factors, and Bacteriological Profile of Respiratory Isolates from Ventilated Patients: Ventilator-Associated Event versus NonVentilator-Associated Event Cases

Sharma¹,

Das²,

Mishra³

et al. 2021

Indian Journal of Respiratory Care

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Incidence of ventilator associated events among intubated patients in neurosurgery ICU of a tertiary health centre in India

Cited by 3 publications

References 8 publications

Ventilator associated events:incidence, microbiological profile and outcome in the intensive care unit in a tertiary hospital of eastern Nepal

Ventilator associated events:incidence, microbiological profile and outcome in the intensive care unit in a tertiary hospital of eastern Nepal

Prevalence of ventilator-associated events and antibiogram of bacterial isolates of ventilator-associated pneumonia in a tertiary care hospital of Uttarakhand

Comparative Study of Demographic Profile, Mortality, Risk Factors, and Bacteriological Profile of Respiratory Isolates from Ventilated Patients: Ventilator-Associated Event versus NonVentilator-Associated Event Cases

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