Clinical significance of ventilator-associated event

Abstract

Purpose: A novel surveillance algorithm of ventilator-associated event (VAE) was introduced to overcome the subjectivity of conventional ventilator-associated pneumonia. We investigated the risk factors and prognostic values of VAE.

Methods: We conducted a retrospective study of 869 patients treated with mechanical ventilation for greater than or equal to 2 calendar days from January 2013 to June 2014. We compared the episodes of mechanical ventilation with or without VAE and analyzed risk factors and clinical outcomes of VAE.

Results: Among 1031 episodes of mechanical ventilation, 92 episodes were complicated with VAE. VAE occurred more frequently when the initial causes of mechanical ventilation were trauma (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.1-6.3) and pulmonary edema (OR, 2.4; 95% CI, 1.2-4.7). VAE was significantly associated with prolonged mechanical ventilation (5 vs 12 days; P<.001), reduced rate of successful extubation (50.1% vs 17.5%; P<.001), and increased 30-day mortality (35.6% vs 74.2%; P<.001). VAE was a significant risk factor of 30-day mortality on multivariate regression analysis (OR, 3.6; 95% CI, 2.0-6.6; P<.001).

Conclusions: Patients treated with mechanical ventilation due to pulmonary edema or trauma had increased risk of VAE, with its development indicative of adverse clinical outcomes.

Keywords: Pulmonary edema; Trauma; Ventilator-associated event; Ventilator-associated pneumonia.