PD081 - POST-PROCEDURE TRACHEOBRONCHITIS (ID 1916)
Abstract
Backgrounds:
Though ventilator-associated tracheobronchitis (VAT) is widely accepted as a distinct clinical entity in children and adults, its intermediary role in development of ventilator-associated pneumonia (VAP) and whether early treatment of VAT reduces risk of subsequent VAP remains uncertain. Tracheobronchitis also can occur during the first 48 hours of mechanical ventilation or after airway manipulation (post-procedure tracheobronchitis, PPT). Our aim was to characterize the proportion of VAT and VAP preceded by PPT and VAT, respectively.
Methods:
Cohort study using retrospective review of medical records and prospectively collected quality improvement database from January 2017 to March 2020 in a 16-bed-PICUs in Spain. PPT/VAT/VAP were assessed using the 2008-CDC definition. Children diagnosed from VAT or VAP were included. All VAT/VAP were treated with antibiotics.
Results:
A total of 6,707 ventilator-days and 63 ventilator-associated respiratory infections (VARI) were analyzed. Rates of VAT, VAP and VARI for this population were 7.3, 2 and 9.3 per 1,000 ventilator-days, respectively. Among 63 VARI, there were 49 VAT (77.8%) and 14 VAP (22.2%). Seventeen VARIs corresponded to early-onset VARI (27%) and 46 to late-onset VARI (73%). Five out of 14 VAP (35.7%) and 6 out of 49 VAT (12.2%) were preceded by PPT (p=0.053). No VAT progressed to VAP. PPT was more frequently associated with early-onset VARI than late-onset VARI (7 out of 17 (41.2%) vs 4 out of 46 (8.7%), p=0,003).
Conclusions/Learning Points:
Early treatment of PPT may reduce the incidence of early-onset VARI.
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