Impact of Ventilator-Associated Events on Clinical Outcomes in Mechanically Ventilated Patients: A Retrospective Cohort Study from a Brazilian ICU.

Abstract

Background: Mechanical ventilation is a widely used intervention for critically ill patients in intensive care units. However, it is associated with various complications. The most up-to-date method for monitoring ventilation-related complications is through Ventilator-Associated Events.

Objective: To evaluate the incidence of Ventilator-Associated Events and their impact on major clinical outcomes in patients admitted to the intensive care units.

Methods: This was a single-center retrospective cohort study which all the adult patients who underwent invasive mechanical ventilation were included. The Ventilator-Associated Events identification was performed using an automated algorithm based on criteria established by the Centers for Disease Control and Prevention. Clinical, demographic, and outcome data were extracted from electronic medical records.

Results: A total of 709 patients were analyzed, of whom 39(5.6%) developed Ventilator-Associated Events, resulting in a rate of 5.99 per 1,000 ventilator-days. Patients with Ventilator-Associated Events had significantly longer durations of mechanical ventilation (19.7±27.4 vs. 4.7±7.9 days; p=0.002), intensive care units stay (25.1±24.7 vs. 8.7±11.1 days; p<0.001), and hospital stay (72.7±73.5 vs. 46±98 days;p<0.001).

Conclusion: The occurrence of Ventilator-Associated Events was associated with significantly worse clinical outcomes. The adoption of algorithm-based automated surveillance may enhance early Ventilator-Associated Events detection, representing the first step toward implementing targeted prevention strategies.