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Patient transport from intensive care increases the risk of developing ventilator-associated pneumonia.
Autor – Kollef MH; Von Harz B; Prentice D; Shapiro SD; Silver P; St.John R; Trovillion E
Zeitschrift/Erscheinungsdatum – Chest 1997 Sep;112(3):765-73
STUDY OBJECTIVES:
To determine whether patient transport out of the ICU is associated with an increased risk of developing ventilator-associated pneumonia. DESIGN: Prospective cohort study. SETTING: ICUs of Barnes-Jewish Hospital, a university-affiliated teaching hospital. PATIENTS: Five hundred twenty-one ICU patients requiring mechanical ventilation for 12 h. INTERVENTION: Prospective patient surveillance and data collection. MEASUREMENTS AND RESULTS: The primary outcome measure was the development of ventilator-associated pneumonia. A total of 273 (52.4%) mechanically ventilated patients required at least one transport out of the ICU while 248 (47.6%) patients did not undergo transport. Sixty-six (24.2%) of the transported patients developed ventilator-associated pneumonia compared with 11 (4.4%) patients in the group not undergoing transport (relative risk=5.5; 95% confidence interval [CI]=2.9 to 10.1; p 0.001). Multiple logistic regression analysis demonstrated that a preceding episode of transport out of the ICU was independently associated with the development of ventilator-associated pneumonia (adjusted odds ratio=3.8; 95% CI=2.6 to 5.5; p 0.001). Other variables independently associated with the development of ventilator-associated pneumonia included reintubation, presence of a tracheostomy, administration of aerosols, and male gender. CONCLUSIONS: We conclude that patient transport out of the ICU is associated with an increased risk for the development of ventilator-associated pneumonia.