One-Week versus 2-Day Ventilator Circuit Change in Neonates with Prolonged Ventilation: Cost-Effectiveness and Impact on Ventilator-Associated Pneumonia. (22nd December 2014)

• Record Type: Journal Article
• Authors: Chu, Shih-Ming; Yang, Mei-Chin; Hsiao, Hsiu-Feng; Hsu, Jen-Fu; Lien, Reyin; Chiang, Ming-Chou; Fu, Ren-Huei; Huang, Hsuan-Rong; Hsu, Kuang-Hung; Tsai, Ming-Horng
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 3(2015)
• Page Start: 287
• Page End: 293
• Publication Date: 2014-12-22
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2014.48
• Languages: English
• ISSNs: 0899-823X

Abstract

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. Infect Control Hosp Epidemiol 2014;00(0): 1–7