Patient transport from intensive care increases the risk of developing ventilator-associated pneumonia

M. H. Kollef, B. Von Harz, D. Prentice, S. D. Shapiro, P. Silver, R. S. John, E. Trovillion

Research output: Contribution to journalArticlepeer-review

177 Scopus citations

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 languageEnglish
Pages (from-to)765-773
Number of pages9
JournalCHEST
Volume112
Issue number3
DOIs
StatePublished - 1997

Keywords

  • Critical care
  • Mechanical ventilation
  • Nosocomial pneumonia
  • Outcomes
  • Patient transport

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