INFECCIÓN RESPIRATORIA EN EL PACIENTE CRÍTICO: EVENTOS ASOCIADOS A LA VENTILACION MECANICA

Abstract

A global consensus on VARI classification has been difficult to achieve, mainly due to the high variability in the interpretation of current definitions and the use of different tests for microbiological confirmation. Moreover, many complications in adult patients receiving mechanical ventilation, such as acute respiratory distress syndrome (ARDS), pulmonary edema, atelectasis, and pulmonary embolisms, may be misinterpreted as respiratory infections due to the lack of specificity of specific diagnostic criteria such as chest X-ray. In 2013 the Centers for Disease Control and Prevention (CDC) proposed a new diagnostic algorithm for ventilator-associated events (VAEs). Based on more objective criteria and easily measurable clinical features, incorporates the fraction of inspired oxygen (FiO2) and the positive end-expiratory pressure (PEEP) as surrogated measures of hypoxemia, disregarded the chest radiograph as diagnostic criteria and both included infective and noninfective complications in the surveillance. The EU-VAE project pursuit is to analyze the different definitions, incidences, risk factors, outcomes, and impact of VAEs.A first study, conducted in 13 ICUs from eight countries, adults over 18 years of age on mechanical ventilation for more than 48 hwere eligible. Initial 30 subjects from each participating center were followed up daily for 30 days and recorded the data in a collaborative web database (http://compartint.net/euvae/). Analysis of a total of 2856 ventilator days in 244 patients, identified 33 VAP and 51 VAT episodes. A secondary studyidentified factors associated with VAEs, 163 patients with 76 episodes of VAE were included (34.9 VAE/1,000 mechanical ventilation days.

Date of Award	17 Jul 2020
Original language	Spanish
Supervisor	Benito Almirante Gragera (Director) & Jordi Rello Condomines (Director)