Pneumonia, Ventilator-Associated
Conditions
Keywords
Infant, Newborn, Neonatal intensive care unit, Ventilator circuit
Brief summary
The purpose of this study is to determine incidence of ventilator-associated pneumonia compared between weekly and no routine ventilator circuit changes in neonatal intensive care unit
Detailed description
Parents were received informed consent. Enrolled neonates was randomly assigned to 2 groups as 7-day ventilator circuit change and no change group by computerization with allocated of concealment. The investigation team opened the next sequentially numbered study pack, which was stored in the neonatal unit. The assignment sequence was generated with balance within random block sizes of 4. Stratification according to birthweight was done before randomization to control for differences in patient populations. Patient characteristics were recorded as gestational age, sex, birthweight, underlying disease, date of intubation, date of extubation, duration of mechanical ventilator, reintubation, length of hospital stay, parenteral nutrition, medication (H2-blocker, PPI, narcotic drugs), transfusion and oral immune therapy. Laboratory data and radiographic data were recorded. Both groups received similarly care as the nurse was assigned to take care of patient in ratio 1-2 patients: 1 nurse, new disposable circuits were use in both groups and the VAP prevention protocol and the endotracheal suctioning protocol which followed by an American Academy of Respiratory Care (AARC) clinical practice guidelines were performed in both groups. When the VAP was suspected the radiographic data were reviewed by two pediatric radiologists on the day of diagnosis, 3 days prior to the diagnosis and/or 2 and 7 days after diagnosis to confirm diagnosis of VAP if there is different in the results, the consensus must be made.
Interventions
DEVICEInfant Ventilator Circuit Dual Heated with Autofeed Chamber
Sponsors
Prince of Songkla University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
1 Days to 1 Years
Healthy volunteers
No
Inclusion criteria
* All neonates who admitted at neonatal intensive care unit (NICU) and required ventilator support with both intubated at time of neonatal resuscitation and within the NICU as indicated
Exclusion criteria
* Patient was extubated or died within 2 calendar days of endotracheal intubation * Pneumonia was diagnosed before intubation * Outborn who was intubated before referred * Parents declined to participate * Incompatibility of disposable circuits and ventilator * Chromosome abnormality or moribund
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| incidence of ventilator-associated pneumonia (percentage of ventilator-associated pneumonia (events)/mechanically ventilated infant) | within the first 30 days (plus or minus 7 days) after extubation | percentage of ventilator-associated pneumonia (events)/mechanically ventilated infant |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| incidence of ventilator-associated pneumonia (ventilator-associated pneumonia (events)/1,000 ventilator days) | within the first 30 days (plus or minus 7 days) after extubation | ventilator-associated pneumonia (events)/1,000 ventilator days |
| Mortality rate | within the first 30 days (plus or minus 7 days) after discharge | pneumonia-specific mortality within 7 days and at discharge |
Countries
Thailand
Outcome results
None listed