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vap, vac

Erica S Shenoy, Eric S Rosenthal, Yu-Ping Shao, Siddharth Biswal, Manohar Ghanta, Erin E Ryan, Dolores Suslak, Nancy Swanson, Valdery Moura Junior, David C Hooper, M Brandon Westover
OBJECTIVETo validate a system to detect ventilator associated events (VAEs) autonomously and in real time.DESIGNRetrospective review of ventilated patients using a secure informatics platform to identify VAEs (ie, automated surveillance) compared to surveillance by infection control (IC) staff (ie, manual surveillance), including development and validation cohorts.SETTINGThe Massachusetts General Hospital, a tertiary-care academic health center, during January-March 2015 (development cohort) and January-March 2016 (validation cohort)...
May 17, 2018: Infection Control and Hospital Epidemiology
Duraid Younan, Russell Griffin, Ahmed Zaky, Jean-Francois Pittet, Bernard Camins
BACKGROUND: The Centers for Disease Control and Prevention (CDC) replaced its definition for ventilator-associated pneumonia (VAP) in 2013. The aim of the current study is to compare the outcome of burn patients with ventilator associated events (VAEs). METHODS: Burn patients with at least two days of ventilator support were identified from the registry between 2013 and 2016. Kruskal-Wallis and Fisher's exact tests were utilized for continuous and categorical variables, respectively...
October 31, 2017: American Journal of Surgery
Hidetsugu Kobayashi, Shigehiko Uchino, Masanori Takinami, Shoichi Uezono
BACKGROUND: The Centers for Disease Control and Prevention recently released a surveillance definition for respiratory complications in ventilated patients, ventilator-associated events (VAEs), to replace ventilator-associated pneumonia (VAP). VAEs consist of ventilator-associated conditions (VAC), infection-related ventilator-associated complications (IVAC), and possible VAP. A duration of mechanical ventilation of at least 4 d is required to diagnose VAE. However, the observed duration of mechanical ventilation was < 4 d in many previous studies...
November 2017: Respiratory Care
Yunzhou Fan, Fang Gao, Yanyan Wu, Jie Zhang, Ming Zhu, Lijuan Xiong
BACKGROUND: Ventilator-associated event (VAE) is a new surveillance paradigm for monitoring complications in mechanically ventilated patients in intensive care units (ICUs). The National Healthcare Safety Network replaced traditional ventilator-associated pneumonia (VAP) surveillance with VAE surveillance in 2013. The objective of this study was to assess the consistency between VAE surveillance and traditional VAP surveillance. METHODS: We systematically searched electronic reference databases for articles describing VAE and VAP in ICUs...
October 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
W S Chen, J Liu, H Liu, Y Y Song, H Y Chen, R Wang, Y P Zhang, W Jiang, H F Li, S Q Li, S M Zhang, B Liu, X Zhang, W H Zhang
OBJECTIVE: The aim of this study was to prospectively investigate the incidence of ventilator associated events (VAEs) in intensive care units (ICUs) among adult patients, and to evaluate the correlation between VAEs and ventilator associated pneumonia (VAP). METHODS: A prospective 3-month cohort study (January 2015 to March 2015) was carried out. VAEs were divided into three groups: with ventilator-associated condition (VAC), with infection related ventilator-associated complication (IVAC) and with possible VAP (PVAP)...
August 10, 2016: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Elias Iosifidis, Elpis Chochliourou, Asimenia Violaki, Elisavet Chorafa, Stavroula Psachna, Afroditi Roumpou, Maria Sdougka, Emmanuel Roilides
OBJECTIVE To evaluate the new adult Centers for Disease Control and Prevention (CDC) ventilator-associated event (VAE) module in critically ill children and compare with the traditionally used CDC definition for ventilator-associated pneumonia (VAP). DESIGN Retrospective observational study of mechanically ventilated children in a pediatric intensive care unit in Greece January 1-December 31, 2011. METHODS Assessment of new adult CDC VAE module including 3 definition tiers: ventilator-associated condition (VAC), infection-related VAC, and possible/probable ventilator-associated pneumonia (VAE-VAP); comparison with traditional CDC criteria for clinically defined pneumonia in mechanically ventilated children (PNEU-VAP)...
October 2016: Infection Control and Hospital Epidemiology
Shichao Zhu, Lin Cai, Chunhua Ma, Hongmei Zeng, Hua Guo, Xiaoqing Mao, Chenghui Zeng, Xiaohong Li, Hua Zhao, Yongfang Liu, Shilian Liu, Juhua Sun, Ling Zhang, Tingyong Peng, Mina Dong, Liping Chen, Zhiyong Zong
OBJECTIVE: The Centers for Disease Control and Prevention (CDC) has developed an approach to ventilator-associated events (VAE) surveillance. Using these methods, this study was performed to investigate VAE incidences and to test whether VAEs are associated with poorer outcomes in China. DESIGN: A 4-month, prospective multicenter surveillance study between April and July 2013. SETTING: Our study included 15 adult intensive care units (ICUs) of 15 hospitals in China...
December 2015: Infection Control and Hospital Epidemiology
Colleen M Stoeppel, Evert A Eriksson, Kenneth Hawkins, Alexander Eastman, Steven Wolf, Joseph Minei, Christian T Minshall
BACKGROUND: In 2012, the National Healthcare Safety Network presented a new surveillance definition for ventilator-associated events (VAEs) to objectively define worsening pulmonary status in ventilated patients. VAE subcategories, ventilator-associated condition (VAC), infection-related VAC, and probable ventilator-associated pneumonia (PrVAP), were vetted predominantly in medical intensive care units. Our goal was to evaluate how well VAE criteria characterize pulmonary complications in surgical intensive care unit (SICU) patients...
December 2014: Journal of Trauma and Acute Care Surgery
Michael Klompas
The Centers for Disease Control and Prevention (CDC) released a new surveillance concept called ventilator-associated conditions (VACs) in early 2013. VAC was created to overcome some of the limitations of traditional ventilator-associated pneumonia (VAP) definitions, including their complexity, subjectivity, and insensitivity to complications other than pneumonia. VAC is defined by sustained increases in ventilator support after ≥2 days of stable or decreasing settings. The VAC definition was designed to be objective, reproducible, and amenable to automated analysis...
October 2014: Current Infectious Disease Reports
Anthony F Boyer, Noah Schoenberg, Hilary Babcock, Kathleen M McMullen, Scott T Micek, Marin H Kollef
BACKGROUND: The Centers for Disease Control and Prevention has shifted policy away from using ventilator-associated pneumonia (VAP) and toward using ventilator-associated conditions (VACs) as a marker of ICU quality. To date, limited prospective data regarding the incidence of VAC among medical and surgical ICU patients, the ability of VAC criteria to capture patients with VAP, and the potential clinical preventability of VACs are available. METHODS: This study was a prospective 12-month cohort study (January 2013 to December 2013)...
January 2015: Chest
André C K B Amaral, Michael W Holder
PURPOSE: Delays in antimicrobial therapy increase mortality in ventilator-associated pneumonia (VAP). The more objective ventilator-associated complications (VAC) are increasingly used for quality reporting. It is unknown if delays in antimicrobial administration, after patients meet VAC criteria, leads to worse outcomes. MATERIALS AND METHODS: Cohort of 81 episodes of antimicrobial treatment for VAP. We compared mortality, superinfections and treatment failures conditional on the timing of identification of VAC...
2014: PloS One
Armand Mekontso Dessap, Sandrine Katsahian, Ferran Roche-Campo, Hugo Varet, Achille Kouatchet, Vinko Tomicic, Gaetan Beduneau, Romain Sonneville, Samir Jaber, Michael Darmon, Diego Castanares-Zapatero, Laurent Brochard, Christian Brun-Buisson
BACKGROUND: Pulmonary edema may alter alveolar bacterial clearance and infectivity. Manipulation of fluid balance aimed at reducing fluid overload may, therefore, influence ventilator-associated pneumonia (VAP) occurrence in intubated patients. The objective of the present study was to assess the impact of a depletive fluid-management strategy on ventilator-associated complication (VAC) and VAP occurrence during weaning from mechanical ventilation. METHODS: We used data from the B-type Natriuretic Peptide for the Fluid Management of Weaning (BMW) randomized controlled trial performed in nine ICUs across Europe and America...
July 2014: Chest
Peter M C Klein Klouwenberg, Maaike S M van Mourik, David S Y Ong, Janneke Horn, Marcus J Schultz, Olaf L Cremer, Marc J M Bonten
RATIONALE: Accurate surveillance of ventilator-associated pneumonia (VAP) is hampered by subjective diagnostic criteria. A novel surveillance paradigm for ventilator-associated events (VAEs) was introduced. OBJECTIVES: To determine the validity of surveillance using the new VAE algorithm. METHODS: 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...
April 15, 2014: American Journal of Respiratory and Critical Care Medicine
Shelley S Magill, Michael Klompas, Robert Balk, Suzanne M Burns, Clifford S Deutschman, Daniel Diekema, Scott Fridkin, Linda Greene, Alice Guh, David Gutterman, Beth Hammer, David Henderson, Dean Hess, Nicholas S Hill, Teresa Horan, Marin Kollef, Mitchell Levy, Edward Septimus, Carole VanAntwerpen, Don Wright, Pamela Lipsett
OBJECTIVE: To develop and implement an objective, reliable approach to surveillance for ventilator-associated events in adult patients. DESIGN: The Centers for Disease Control and Prevention (CDC) convened a Ventilator-Associated Pneumonia (VAP) Surveillance Definition Working Group in September 2011. Working Group members included representatives of stakeholder societies and organizations and federal partners. MAIN RESULTS: The Working Group finalized a three-tier, adult surveillance definition algorithm for ventilator-associated events...
November 2013: Critical Care Medicine
John Muscedere, Tasnim Sinuff, Daren K Heyland, Peter M Dodek, Sean P Keenan, Gordon Wood, Xuran Jiang, Andrew G Day, Denny Laporta, Michael Klompas
BACKGROUND: Ventilator-associated conditions (VACs) and infection-related ventilator-associated complications (iVACs) are the Centers for Disease Control and Prevention's new surveillance paradigms for patients who are mechanically ventilated. Little is known regarding the clinical impact and preventability of VACs and iVACs and their relationship to ventilator-associated pneumonia (VAP). We evaluated these using data from a large, multicenter, quality-improvement initiative. METHODS: We retrospectively applied definitions for VAC and iVAC to data from a prospective time series study in which VAP clinical practice guidelines were implemented in 11 North American ICUs...
November 2013: Chest
Philip E Grgurich, Jana Hudcova, Yuxiu Lei, Akmal Sarwar, Donald E Craven
PURPOSE OF REVIEW: The aim is to discuss the clinical, microbiologic, and radiological criteria used in the diagnosis of ventilator-associated pneumonia (VAP), distinguish between ventilator-associated tracheobronchitis (VAT) and VAP, and reconcile the proposed Centers for Disease Control surveillance criteria with clinical practice. RECENT FINDINGS: Numerous ventilator-associated complications (VACs), including VAP and VAT, may occur in critically ill, intubated patients...
April 2013: Current Opinion in Infectious Diseases
Marin H Kollef
Acute respiratory failure represents the most common condition requiring admission to an adult intensive care unit. Ventilator-associated pneumonia (VAP) has been used as a marker of quality for patients with respiratory failure. Hospital-based process-improvement initiatives to prevent VAP have been successfully used. The use of ventilator-associated complications (VACs) has been proposed as an objective marker to assess the quality of care for this patient population. The use of evidence-based bundles targeting the reduction of VACs, as well as the conduct of prospective studies showing that VACs are preventable complications, are reasonable first-steps in addressing this important clinical problem...
January 2013: Critical Care Clinics
Yoshiro Hayashi, Kenichiro Morisawa, Michael Klompas, Mark Jones, Hiran Bandeshe, Robert Boots, Jeffrey Lipman, David L Paterson
BACKGROUND: Hospitals and quality improvement agencies are vigorously focusing on reducing rates of hospital-acquired infection. Ventilator-associated pneumonia (VAP) is notoriously difficult to diagnose and surveillance is thwarted by the subjectivity of many components of the surveillance definition. Alternative surveillance strategies are needed. Ventilator-associated complications (VAC) is a simple, objective measure of respiratory deterioration. METHODS: VAC is defined by increases in fraction of inspired oxygen (FiO(2)) by ≥ 15% or positive end-expiratory pressure (PEEP) by ≥ 2...
February 2013: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Michael Klompas, Yosef Khan, Kenneth Kleinman, R Scott Evans, James F Lloyd, Kurt Stevenson, Matthew Samore, Richard Platt
BACKGROUND: Ventilator-associated pneumonia (VAP) surveillance is time consuming, subjective, inaccurate, and inconsistently predicts outcomes. Shifting surveillance from pneumonia in particular to complications in general might circumvent the VAP definition's subjectivity and inaccuracy, facilitate electronic assessment, make interfacility comparisons more meaningful, and encourage broader prevention strategies. We therefore evaluated a novel surveillance paradigm for ventilator-associated complications (VAC) defined by sustained increases in patients' ventilator settings after a period of stable or decreasing support...
2011: PloS One
Andreas Braun, Felix Krause, Matthias Frentzen, Søren Jepsen
OBJECTIVE: The recently introduced Vector-system (Duerr Dental, Bietigheim-Bissingen, Germany) is recommended to be used in conjunction with different insert tips and irrigation fluids. The aim of the study was to assess subgingival calculus removal depending on the mode of operation and to compare the results to conventional methods for root debridement. METHODS: Sixty extracted human teeth with calculus on the root surface were treated in an artificial periodontal pocket model using six methods: Vector-system with metal probe insert (VPP) or metal curette insert (VPC), both used with polishing fluid, Vector-system with metal probe insert (VAP) or metal curette insert (VAC), both used with abrasive fluid, EMS-ultrasonic system (U) and hand instrument (Gracey curette)...
February 2005: Journal of Periodontal Research
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