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ventilator-associated pneumonia

Ashley Gionfriddo, Mika L Nonoyama, Peter C Laussen, Peter N Cox, Megan Clarke, Alejandro A Floh
OBJECTIVES: To promote standardization, the Centers for Disease Control and Prevention introduced a new ventilator-associated pneumonia classification, which was modified for pediatrics (pediatric ventilator-associated pneumonia according to proposed criteria [PVAP]). We evaluated the frequency of PVAP in a cohort of children diagnosed with ventilator-associated pneumonia according to traditional criteria and compared their strength of association with clinically relevant outcomes. DESIGN: Retrospective cohort study...
March 15, 2018: Pediatric Critical Care Medicine
Catia Cilloniz, Miquel Ferrer, Adamanthia Liapikou, Carolina Garcia-Vidal, Albert Gabarrus, Adrian Ceccato, Jorge Puig de La Bellacasa, Francesco Blasi, Antoni Torres
Question: To assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in ICU patients with community-acquired pneumonia (CAP) using the Berlin definition. Methods: We prospectively enrolled consecutive mechanically-ventilated ICU adults with CAP over 20 years, compared with mechanically-ventilated patients without ARDS. The main outcome was 30-day mortality. Results: Among 5,334 patients hospitalized with CAP, 930 (17%) were admitted to the ICU, and 432 required mechanical ventilation; 125 (29%) cases met the Berlin ARDS criteria...
March 15, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Sakshi Mathur Dhar, Matthew D Breite, Stephen L Barnes, Jacob A Quick
BACKGROUND: Pulmonary contusions are thought to worsen outcomes. We aimed to evaluate the effects of pulmonary contusion on mechanically ventilated trauma subjects with severe thoracic injuries and hypothesized that contusion would not increase morbidity. METHODS: We conducted a single-center, retrospective review of 163 severely injured trauma subjects (injury severity score ≥ 15) with severe thoracic injury (chest abbreviated injury score ≥ 3), who required mechanical ventilation for >24 h at a verified Level 1 trauma center...
March 13, 2018: Respiratory Care
Shao-Ting Wang, Xue-Feng Sun
Objective To systemically evaluate the the role of statins in prevention and treatment of community-acquired pneumonia (CAP). Methods A computer-based searching was conducted in PubMed,EMbase,Cochrane Library,Wanfang,and CNKI database up to October 2016. Totally 21 eligible articles were retrieved. According to the Cochrane Handbook 5.0 or Newcastle-Ottawa Scale (NOS) quality evaluation criteria,two independent reviewers carried out literature screening,data retraction,and quality evaluation. Meta-analysis was conducted with RevMan 5...
February 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Demosthenes Makris, Efi Petinaki, Vasssiliki Tsolaki, Efstratios Manoulakas, Konstantinos Mantzarlis, Olimpia Apostolopoulou, Dimitrios Sfyras, Epaminondas Zakynthinos
Background: Retrospective studies have reported good clinical success rates using colistin as monotherapy to treat Acinetobacter baumannii ventilator-associated pneumonia (VAP), comparable to that obtained with colistin combined with other antibiotics. However, inadequate penetration into the pulmonary parenchyma for colistin has been shown in animal models. Aim: The aim of the study was to study prospectively the outcome, measured as clinical response and survival, of intravenously administered colistin versus colistin combined with high-dose ampicillin-sulbactam in Intensive Care Unit (ICU) patients with multiresistant A...
February 2018: Indian Journal of Critical Care Medicine
Nathaniel J Rhodes, Caroline E Cruce, J Nicholas O'Donnell, Richard G Wunderink, Alan R Hauser
PURPOSE OF REVIEW: Hospital-acquired and ventilator-associated pneumonia (VAP) are frequent causes of infection among critically ill patients. VAP is the most common hospital-acquired bacterial infection among mechanically ventilated patients. Unfortunately, many of the nosocomial Gram-negative bacteria that cause VAP are increasingly difficult to treat. Additionally, the evolution and dissemination of multi- and pan-drug resistant strains leave clinicians with few treatment options. VAP patients represent a dynamic population at risk for antibiotic failure and under-dosing due to altered antibiotic pharmacokinetic parameters...
March 6, 2018: Current Infectious Disease Reports
Sebastien Tanaka, Claire Geneve, Gianpiero Tebano, Nathalie Grall, Pascal Piednoir, Régis Bronchard, Mathieu Godement, Enora Atchade, Pascal Augustin, Herve Mal, Yves Castier, Philippe Montravers, Mathieu Desmard
BACKGROUND: Bacterial respiratory infections (BRI) are major complications contributing to increased morbidity and mortality after lung transplantation (LT). This study analyzed epidemiology and outcome of 175 consecutive patients developing BRI in ICU after LT between 2006 and 2012. METHODS: Three situations were described: colonization determined in donors and recipients, pneumonia and tracheobronchitis during the first 28 postoperative days. Severity score, demographic, bacteriologic and outcome data were collected...
March 5, 2018: BMC Pulmonary Medicine
Phunsup Wongsurakiat, Sirapat Tulatamakit
Background We wanted to determine the impact of combined Clinical Pulmonary Infection Score (CPIS) and a spot serum procalcitonin (PCT)-guided protocol to shorten the duration of antibiotic treatment in patients with ventilator-associated pneumonia (VAP), mainly caused by nonfermentative gram-negative bacilli (NF-GNB). Methods Patients with VAP who received appropriate antibiotics for 7 days, temperature ⩽ 37.8°C, without shock, and CPIS ⩽ 6 were allocated to the PCT group or conventional group according to the treating physicians' decisions...
January 2018: Therapeutic Advances in Respiratory Disease
Kevin Bihan, Noël Zahr, Marie-Hélène Becquemin, Xiao Lu, Jean-François Bertholon, Corinne Vezinet, Charlotte Arbelot, Antoine Monsel, Jean-Jacques Rouby, Olivier Langeron, Qin Lu
Objectives: Nebulized colistimethate sodium (CMS) can be used to treat ventilator-associated pneumonia caused by MDR bacteria. The influence of the diluent volume of CMS on aerosol delivery has never been studied. The main objectives of the study were to compare aerosol particle characteristics and plasma and urine pharmacokinetics between two diluent volumes in patients treated with nebulized CMS. Methods: A crossover study was conducted in eight patients receiving nebulized CMS every 8 h...
February 28, 2018: Journal of Antimicrobial Chemotherapy
Wei Li, Xianfen Cheng, Linying Guo, Hongri Li, Chunrong Sun, Xiaodai Cui, Qi Zhang, Guowei Song
We assessed the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and community-acquired pneumonia (CAP) among Chinese children.This observational study examined children aged 3 days to 14 years (n = 1582) from the Capital Institute of Pediatrics in 2009 to 2011. There were 797 children in the CAP group and 785 controls. The CAP group was divided into 2 groups: a pneumonia group and pneumonia-induced sepsis group. The serum 25(OH)D level was estimated using micro whole blood chemiluminescence...
January 2018: Medicine (Baltimore)
Ziyaattin Karakuzu, Remzi Iscimen, Halis Akalin, Nermin Kelebek Girgin, Ferda Kahveci, Melda Sinirtas
BACKGROUND Ventilator-associated pneumonia (VAP) is a nosocomial infection commonly seen in patients in intensive care units (ICU). This study aimed to analyze factors affecting prognosis of patients diagnosed with VAP. MATERIAL AND METHODS Critically ill patients with VAP were retrospectively evaluated between June 2002 and June 2011 in the ICU. VAP diagnosis was made according to 2005 ATS/IDSA (Infectious Diseases Society of America/American Thoracic Society) criteria. First pneumonia attacks of patients were analyzed...
March 5, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
G Ortiz, M Garay, D Mendoza, P Cardinal-Fernández
INTRODUCTION: Acute respiratory distress syndrome (ARDS) is an inflammatory lung disorder, and its pathological hallmark is diffuse alveolar damage (DAD). Given that open lung biopsy (OLB) can sometimes result in severe side effects, it is rarely performed in patients with ARDS. AIM: The aims of this study were to describe: (a) the rate of treatment change associated with the histological result; and (b) the incidence of side effects induced by OLB. DESIGN AND PATIENTS: A retrospective, single-center, descriptive observational study was carried out in Hospital Santa Clara (Bogotá, Colombia) from February 2007 to January 2014...
February 28, 2018: Medicina Intensiva
Michael E Wilson, Abdul M Majzoub, Claudia C Dobler, J Randall Curtis, Tarek Nayfeh, Bjorg Thorsteinsdottir, Amelia K Barwise, Jon C Tilburt, Ognjen Gajic, Victor M Montori, M Hassan Murad
OBJECTIVES: To assess the effectiveness of noninvasive ventilation in patients with acute respiratory failure and do-not-intubate or comfort-measures-only orders. DATA SOURCES: MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science from inception to January 1, 2017. STUDY SELECTION: Studies of all design types that enrolled patients in the ICU or hospital ward who received noninvasive ventilation and had preset do-not-intubate or comfort-measures-only orders...
March 1, 2018: Critical Care Medicine
James C Hurley
Staphylococcus aureus ( S. aureus ) is a common Ventilator-Associated Pneumonia (VAP) isolate. The objective here is to define the extent and possible reasons for geographic variation in the incidences of S. aureus -associated VAP, MRSA-VAP and overall VAP. A meta-regression model of S. aureus -associated VAP incidence per 1000 Mechanical Ventilation Days (MVD) was undertaken using random effects methods among publications obtained from a search of the English language literature. This model incorporated group level factors such as admission to a trauma ICU, year of publication and use of bronchoscopic sampling towards VAP diagnosis...
February 27, 2018: Microorganisms
Elena Véliz, Alberto Fica
BACKGROUND: Ventilator-associated pneumonia (VAP) is an adverse event that increases morbidity, mortality and costs due to a prolonged stay and requirement of microbiological studies and antimicrobial therapy. There is not recent data of VAP costs in Chile. AIM: To evaluate additional costs in adult patients with VAP compared to controls in a general hospital in the Metropolitan Area. PATIENTS AND METHODS: Use of the PAHO paired casecontrol protocol for cost evaluation associated to nosocomial infections and estimation of cost in excess per VAP event...
October 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Agnar Bjarnason, Johan Westin, Magnus Lindh, Lars-Magnus Andersson, Karl G Kristinsson, Arthur Löve, Olafur Baldursson, Magnus Gottfredsson
Background: The microbial etiology of community-acquired pneumonia (CAP) is often unclear in clinical practice, and previous studies have produced variable results. Population-based studies examining etiology and incidence are lacking. This study examined the incidence and etiology of CAP requiring hospitalization in a population-based cohort as well as risk factors and outcomes for specific etiologies. Methods: Consecutive admissions due to CAP in Reykjavik, Iceland were studied...
February 2018: Open Forum Infectious Diseases
F Rabello, V E Araújo, Sms Magalhães
OBJECTIVE: To summarize evidence regarding the effectiveness of using chlorhexidine for oral healthcare on patients in the intensive care unit for the prevention of nosocomial pneumonia and ventilator-associated pneumonia. METHODS: This overview of systematic reviews was developed using articles found in PUBMED, Cochrane Library, LILACS, CRD, CINHAL, manual search and grey literature. RESULTS: Of the total 16 systematic reviews, 14 included meta-analysis...
February 23, 2018: International Journal of Dental Hygiene
Farhad Najmeddin, Bita Shahrami, Sayna Azadbakht, Mehrnoush Dianatkhah, Mohammad Reza Rouini, Atabak Najafi, Arezoo Ahmadi, Hamidreza Sharifnia, Mojtaba Mojtahedzadeh
INTRODUCTION: Classically, aminoglycosides are known to have low penetration into the lung tissue. So far, no study has been conducted on human adult patients to evaluate amikacin concentration in epithelial lining fluid (ELF) of the alveoli. Therefore, convincing data are not available from the perspective of pharmacokinetics to support the fact that a dosage of 20 mg/kg of amikacin is sufficient to treat patients with ventilator-associated pneumonia (VAP). METHOD: This was a pilot study of amikacin concentration measurement in the alveolar site of action in critically ill adult patients with VAP who required aminoglycoside therapy...
January 1, 2018: Journal of Intensive Care Medicine
V A Novikov, G M Galstyan, I An E G Gemdzh, I E Kostina, M K Gitis
PURPOSE: To compare the accuracy of bedside lung ultrasound (LUS) and chest computed tomography (CT) for the de- tection of lung lesions in patients with hematological malignancies and acute respiratory failure (ARF). MATERIALS AND METHODS: 39 patients with hematological malignancies and ARF were enrolled in prospective study. The investigation of the patients included LUS, chest C, extravascular lung water index (EVLW) by transpulmonary ther- modilution, and bronchoalveolar lavage (BAL)...
September 2017: Anesteziologiia i Reanimatologiia
Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
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