Idioma:

Electronic Implementation of a Novel Surveillance Paradigm for Ventilator-associated Events: Feasibility and Validation

KLEIN KLOUWENBERG, Peter M. C ; VAN MOURIK, Maaike S. M ; ONG, David S. Y ; HORN, Janneke ; SCHULTZ, Marcus J ; CREMER, Olaf L ; BONTEN, Marc J. M

American journal of respiratory and critical care medicine, 2014-04, Vol.189 (8), p.947-955 [Periódico revisado por pares]

New York, NY: American Thoracic Society

Texto completo disponível

Citações Citado por

Enviar para

Título:
Electronic Implementation of a Novel Surveillance Paradigm for Ventilator-associated Events: Feasibility and Validation
Autor: KLEIN KLOUWENBERG, Peter M. C ; VAN MOURIK, Maaike S. M ; ONG, David S. Y ; HORN, Janneke ; SCHULTZ, Marcus J ; CREMER, Olaf L ; BONTEN, Marc J. M
Assuntos: Aged ; Algorithms ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cohort analysis ; Cohort Studies ; Feasibility Studies ; Female ; General aspects ; Health care ; Hospitals, University ; Human infectious diseases. Experimental studies and models ; Humans ; Infections ; Infectious diseases ; Intensive care medicine ; Intensive Care Units ; Length of Stay - statistics & numerical data ; Male ; Medical sciences ; Middle Aged ; Mortality ; Netherlands - epidemiology ; Patient Admission ; Patients ; Pneumology ; Pneumonia ; Pneumonia, Ventilator-Associated - diagnosis ; Pneumonia, Ventilator-Associated - epidemiology ; Pneumonia, Ventilator-Associated - mortality ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Sensitivity and Specificity ; Sentinel Surveillance ; Surveillance ; Survival Rate ; Validity ; Ventilators ; Weaning
É parte de: American journal of respiratory and critical care medicine, 2014-04, Vol.189 (8), p.947-955
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ObjectType-Article-2
ObjectType-Feature-1
Descrição: Accurate surveillance of ventilator-associated pneumonia (VAP) is hampered by subjective diagnostic criteria. A novel surveillance paradigm for ventilator-associated events (VAEs) was introduced. To determine the validity of surveillance using the new VAE algorithm. Prospective cohort study in two Dutch academic medical centers (2011-2012). VAE surveillance was electronically implemented and included assessment of (infection-related) ventilator-associated conditions (VAC, IVAC) and VAP. Concordance with ongoing prospective VAP surveillance was assessed, along with clinical diagnoses underlying VAEs and associated mortality of all conditions. Consequences of minor differences in electronic VAE implementation were evaluated. The study included 2,080 patients with 2,296 admissions. Incidences of VAC, IVAC, VAE-VAP, and VAP according to prospective surveillance were 10.0, 4.2, 3.2, and 8.0 per 1000 ventilation days, respectively. The VAE algorithm detected at most 32% of the patients with VAP identified by prospective surveillance. VAC signals were most often caused by volume overload and infections, but not necessarily VAP. Subdistribution hazards for mortality were 3.9 (95% confidence interval, 2.9-5.3) for VAC, 2.5 (1.5-4.1) for IVAC, 2.0 (1.1-3.6) for VAE-VAP, and 7.2 (5.1-10.3) for VAP identified by prospective surveillance. In sensitivity analyses, mortality estimates varied considerably after minor differences in electronic algorithm implementation. Concordance between the novel VAE algorithm and VAP was poor. Incidence and associated mortality of VAE were susceptible to small differences in electronic implementation. More studies are needed to characterize the clinical entities underlying VAE and to ensure comparability of rates from different institutions.
Editor: New York, NY: American Thoracic Society
Idioma: Inglês

Links

Voltar para lista de resultados

Anterior Resultado 10 Avançar Ir para próxima página

Realização: Logos de Redes Sociais:

Electronic Implementation of a Novel Surveillance Paradigm for Ventilator-associated Events: Feasibility and Validation

KLEIN KLOUWENBERG, Peter M. C ; VAN MOURIK, Maaike S. M ; ONG, David S. Y ; HORN, Janneke ; SCHULTZ, Marcus J ; CREMER, Olaf L ; BONTEN, Marc J. M

New York, NY: American Thoracic Society

Buscando em bases de dados remotas. Favor aguardar.