Duration of prehospital intubation is not a risk factor for development of early ventilator-associated pneumonia

Nicholas M Mohr; Karisa K Harland; Dionne Skeete; Kent Pearson; Kent Choi

doi:10.1016/j.jcrc.2014.03.030

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Duration of prehospital intubation is not a risk factor for development of early ventilator-associated pneumonia

Journal article

Peer reviewed

Duration of prehospital intubation is not a risk factor for development of early ventilator-associated pneumonia

Nicholas M Mohr, Karisa K Harland, Dionne Skeete, Kent Pearson and Kent Choi

Journal of critical care, Vol.29(4), pp.539-544

08/2014

DOI: 10.1016/j.jcrc.2014.03.030

PMID: 24793661

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Abstract

Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality among critically ill patients with trauma. Few VAP prevention strategies have been studied in the prehospital environment. The objectives of this study are to measure the association between duration of prehospital intubation and intubation location with subsequent incidence of early (within 5 days) VAP. Single-center retrospective cohort study of all intubated adult (age ≥18 years) patients with trauma presenting to a 711-bed Midwestern Level I trauma center between January 2005 and December 2011 (n = 860). Thirty-five patients (6.4%) were diagnosed as having early VAP during the study period. Using multivariable logistic regression to adjust for age, injury severity score, and year (corresponding to VAP bundle implementation), the duration of intubation prior to hospital admission was not associated with subsequent diagnosis of VAP (adjusted odds ratio, 0.90 per hour; 95% confidence interval, 0.70-1.15). Location of intubation was similarly not associated with VAP. Duration of prehospital intubation and intubation location were not different in patients with trauma who developed early VAP. Further prospective analyses should be conducted to better elucidate the effect of prehospital management on the development of traditionally in-hospital complications.

Pneumonia ventilator-associated

Prevention and control

Wounds and injuries

Emergency medicine

Emergency medical services

Details

Title: Subtitle: Duration of prehospital intubation is not a risk factor for development of early ventilator-associated pneumonia
Creators: Nicholas M Mohr - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
Karisa K Harland - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
Dionne Skeete - Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
Kent Pearson - Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine, Iowa City, IA
Kent Choi - Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
Resource Type: Journal article
Publication Details: Journal of critical care, Vol.29(4), pp.539-544
DOI: 10.1016/j.jcrc.2014.03.030
PMID: 24793661
NLM abbreviation: J Crit Care
ISSN: 0883-9441
eISSN: 1557-8615
Publisher: Elsevier Inc
Language: English
Date published: 08/2014
Academic Unit: Epidemiology; Emergency Medicine; Surgery; Center for Social Science Innovation; Anesthesia; Injury Prevention Research Center; Public Policy Center (Archive); Law Faculty
Record Identifier: 9984024551702771

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