Abstract
Study objective: To determine whether patient transport out of the ICU is associated with an increased risk of developing ventilator-associated pneumonia. Design: Prospective cohort study. Setting: ICUs of Barnes-Jewish Hospital, a university-affiliated teaching hospital. Patients: Five hundred twenty-one ICU patients requiring mechanical ventilation for >12 h. Intervention: Prospective patient surveillance and data collection. Measurements and results: The primary outcome measure was the development of ventilator-associated pneumonia. A total of 273 (52.4%) mechanically ventilated patients required at least one transport out of the ICU while 248 (47.6%) patients did not undergo transport. Sixty-six (24.2%) of the transported patients developed ventilator-associated pneumonia compared with 11 (4.4%) patients in the group not undergoing transport (relative risk=5.5; 95% confidence interval [CI]=2.9 to 10.1; p<0.001). Multiple logistic regression analysis demonstrated that a preceding episode of transport out of the ICU was independently associated with the development of ventilator- associated pneumonia (adjusted odds ratio=3.8; 95% CI=2.6 to 5.5; p<0.001). Other variables independently associated with the development of ventilator- associated pneumonia included reintubation, presence of a tracheostomy, administration of aerosols, and male gender. Conclusions: We conclude that patient transport out of the ICU is associated with an increased risk for the development of ventilator-associated pneumonia.
Original language | English |
---|---|
Pages (from-to) | 765-773 |
Number of pages | 9 |
Journal | CHEST |
Volume | 112 |
Issue number | 3 |
DOIs | |
State | Published - 1997 |
Keywords
- Critical care
- Mechanical ventilation
- Nosocomial pneumonia
- Outcomes
- Patient transport