创伤重症监护病房呼吸机相关事件监测:与呼吸机相关肺炎的发病率、预测值、敏感性、特异性、准确性和一致性的前瞻性研究

IF 1.5
Kulbeer Kaur, Kajal Jain, Manisha Biswal, Surinder Kaur Dayal
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引用次数: 2

摘要

导论:美国疾病控制与预防中心(CDC)在2013年引入了呼吸机相关事件(VAEs)的新定义,取代了长期存在的呼吸机相关肺炎(VAP)定义。引入了呼吸机相关病情(VAC)、感染相关呼吸机相关并发症(IVAC)和可能的呼吸机相关肺炎(PVAP)三个指标。目的:评估三级创伤ICU中所有VAP的发生率,探讨VAE的预测价值及VAE定义对VAP的敏感性。设计:2018年7月至2019年6月在昌迪加尔PGIMER创伤重症监护病房(ICU)进行队列前瞻性研究。材料和方法:对创伤ICU收治的患者进行CDC定义的VAP和VAE标准检查。结果:共观察患者465例。约378例患者纳入研究,4046患者日和3031机械通气(MV)日。PVAP、IVAC、VAC和VAP的发病率分别为2.97、6.60、10.23和9.24 / 1000呼吸机d。诊断VAP的敏感性、特异性、阳性预测值、阴性预测值(NPV)分别为0.61、0.97、0.68、0.97;IVAC分别为0.80、0.97、0.57和0.99;PVAP分别为0.78、0.94、0.25、0.9。Kendall's W检验显示VAP与VAE的一致性很差。Kaur K, Jain K, Biswal M, Dayal SK.创伤重症监护病房呼吸机相关事件监测:与呼吸机相关肺炎的发病率、预测值、敏感性、特异性、准确性和一致性的前瞻性研究。中华检验医学杂志;2009;26(5):584-590。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Ventilator-associated Events Surveillance in a Trauma Intensive Care Unit: A Prospective Study of Incidence, Predictive Values, Sensitivity, Specificity, Accuracy, and Concordance with Ventilator-associated Pneumonia.

Ventilator-associated Events Surveillance in a Trauma Intensive Care Unit: A Prospective Study of Incidence, Predictive Values, Sensitivity, Specificity, Accuracy, and Concordance with Ventilator-associated Pneumonia.

Ventilator-associated Events Surveillance in a Trauma Intensive Care Unit: A Prospective Study of Incidence, Predictive Values, Sensitivity, Specificity, Accuracy, and Concordance with Ventilator-associated Pneumonia.

Introduction: The Centres for Disease Control and Prevention (CDC) introduced a new definition of ventilator-associated events (VAEs) in 2013 in place of longstanding ventilator-associated pneumonia (VAP) definition. Three entities under VAE, ventilator-associated condition (VAC), infection-related ventilator-associated complication (IVAC), and possible ventilator-associated pneumonia (PVAP), were introduced.

Objectives: To assess the incidence of all VAEs in a tertiary care trauma ICU and to find the predictive value of VAE and sensitivity of VAE definitions for VAP.

Design: Cohort prospective study at trauma intensive care unit (ICU) of PGIMER, Chandigarh, from July 2018 till June 2019.

Materials and methods: Patients admitted in trauma ICU were checked for VAP and VAE criteria defined by CDC.

Results: Four hundred and sixty five patients were observed. Around 378 patients were included in the study with 4046 patient days and 3031 mechanical ventilation (MV) days. Incidence rate of PVAP, IVAC, VAC, and VAP was 2.97, 6.60, 10.23, and 9.24 per 1000 ventilator days, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of diagnosing VAP were 0.61, 0.97, 0.68, and 0.97 for VAC; 0.80, 0.97, 0.57, and 0.99 for IVAC; and 0.78, 0.94, 0.25, and 0.9 for PVAP, respectively. Kendall's W test showed that there was very poor concordance between VAP and VAE.

How to cite this article: Kaur K, Jain K, Biswal M, Dayal SK. Ventilator-associated Events Surveillance in a Trauma Intensive Care Unit: A Prospective Study of Incidence, Predictive Values, Sensitivity, Specificity, Accuracy, and Concordance with Ventilator-associated Pneumonia. Indian J Crit Care Med 2022;26(5):584-590.

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