EP381 - VENTILATOR-ASSOCIATED RESPIRATORY INFECTIONS AND EUROPEAN PEDIATRIC VENTILATOR-ASSOCIATED EVENT CRITERIA (ID 1922)
Abstract
Backgrounds:
The Centers for Disease Control and Prevention (CDC) broadened the focus of surveillance from ventilator-associated pneumonia (VAP) to ventilator-associated event (VAE) for quality purposes. We aimed to characterize VAE in pediatric VARI episodes using CDC criteria (adult VAE, children: US-PedVAE) and the European pediatric criteria (EU-PedVAE). Secondary objective: subcategorize ventilator-associated respiratory infections (VARI) using EU-PedVAE definition and compare outcomes between them.
Methods:
Cohort study using retrospective review of medical records and prospectively collected quality improvement VAE/VARI database from January 2017 to March 10th, 2020 in a 16-bed-PICU. VARI, including VAP and ventilator-associated tracheobronchitis (VAT), were assessed using the 2008-CDC definitions. Exclusion criteria: previous ventilation, extracorporeal life support, right-to-left shunt or pulmonary hypertension. In patients with more than one episode of mechanical ventilation (MV), only the first was considered.
Results:
A total of 33 VARI episodes and 1,342 ventilator-days were analyzed. There were 29 VAT (87.9%) and 4 VAP (12.1%). Sixteen (48.5%) corresponded to early-onset VARI. Nine out of 33 VARI fulfilled any criteria: 2 adult VAE, 1 US-PedVAE, and 9 EU-PedVAE criteria. The duration of the episodes of MV in patients suffering from VARI was 10 (8-28) (median, IQR) and the duration of MV from the VARI onset was 5 (2-17). In VARI episodes meeting EU-VAE definition, a median of 7(3-26) ventilator-days from the VARI onset was documented, whereas the median of days from VARI onset to extubation was 4.5 (IQR 2-11.5) on those VARI episodes not meeting EU-VAE criteria (p=0.301).
Conclusions/Learning Points:
All VAE criteria had low prevalence among VARI, being the EU-PedVAE definition the least restrictive. EU-PedVAE criteria might be used to identify VARI with worse outcomes.
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