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artículo

Multinational prospective cohort study of rates and risk factors for ventilator-associated pneumonia over 24 years in 42 countries of Asia, Africa, Eastern Europe, Latin America, a...

Publicado por
Rosenthal, Victor Daniel, Jin, Zhilin, Memish, Ziad A., Rodrigues, Camilla, Myatra, Sheila Nainan, Kharbanda, Mohit, Valderrama-Beltran, Sandra Liliana, Mehta, Yatin, Daboor, Mohammad Abdellatif, Todi, Subhash Kumar, Aguirre-Avalos, Guadalupe, Guclu, Ertugrul, Gan, Chin Seng, Jiménez Alvarez, Luisa Fernanda, Chawla, Rajesh, Hlinkova, Sona, Arjun, Rajalakshmi, Agha, Hala Mounir, Zuniga Chavarria, Maria Adelia, Davaadagva, Narangarav, Mohd Basri, Mat Nor, Gomez, Katherine, Aguilar De Moros, Daisy, Tai, Chian Wern, Sassoe Gonzalez, Alejandro, Aguilar Moreno, Lina Alejandra, Sandhu, Kavita, Janc, Jarosław, Aleman Bocanegra, Mary Cruz, Yildizdas, Dincer, Cano Medina, Yuliana Andrea, Villegas Mota, Maria Isabel, Omar, Abeer Aly, Duszynska, Wieslawa, Belkebir, Souad, El-Kholy, Amani Ali, Abdulaziz Alkhawaja, Safaa, Horhat Florin, George, Medeiros, Eduardo Alexandrino, Tao, Lili, Tumu, Nellie, Elanbya, May Gamar, Dongol, Reshma, Mioljević, Vesna, Raka, Lul, Dueñas, Lourdes, Carreazo, Nilton Yhuri, Dendane, Tarek, Ikram, Aamer, Kanj, Souha S., Petrov, Michael M., Bouziri, Asma, Hung, Nguyen Viet, Belskiy, Vladislav, Elahi, Naheed, Bovera, María Marcela, Yin, Ruijie

Publicado 2023

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Objective: Rates of ventilator-associated pneumonia (VAP) in low- and middle-income countries (LMIC) are several times above those of high-income countries. The objective of this study was to identify risk factors (RFs) for VAP cases in ICUs of LMICs. Design: Prospective cohort study. Setting: This study was conducted across 743 ICUs of 282 hospitals in 144 cities in 42 Asian, African, European, Latin American, and Middle Eastern countries. Participants: The study included patients admitted to ICUs across 24 years. Results: In total, 289,643 patients were followed during 1,951,405 patient days and acquired 8,236 VAPs. We analyzed 10 independent variables. Multiple logistic regression identified the following independent VAP RFs: male sex (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.16-1.28; P <.0001); longer length of stay (LOS), which increased the risk 7% per day (...

artículo

Assessing the impact of a multidimensional approach and an 8-component bundle in reducing incidences of ventilator-associated pneumonia across 35 countries in Latin America, Asia,...

Publicado por
Rosenthal, Victor Daniel, Jin, Zhilin, Yin, Ruijie, Sahu, Suneeta, Rajhans, Prasad, Kharbanda, Mohit, Nair, Pravin K., Mishra, Shakti Bedanta, Chawla, Rajesh, Arjun, Rajalakshmi, Sandhu, Kavita, Rodrigues, Camilla, Dongol, Reshma, Myatra, Sheila Nainan, Mohd-Basri, Mat Nor, Chian-Wern, Tai, Bhakta, Arpita, Bat-Erdene, Ider, Acharya, Subhash P., Alvarez, Gustavo Andres, Moreno, Lina Alejandra Aguilar, Gomez, Katherine, da Jimenez-Alvarez, Luisa Fernanda, Henao-Rodas, Claudia Milena, Valderrama-Beltran, Sandra Liliana, Zuniga-Chavarria, Maria Adelia, Aguirre-Avalos, Guadalupe, Hernandez-Chena, Blanca Estela, Sassoe-Gonzalez, Alejandro, Aleman-Bocanegra, Mary Cruz, Villegas-Mota, Maria Isabel, De Moros, Daisy Aguilar, Castaneda-Sabogal, Alex, Carreazo, Nilton Yhuri, Alkhawaja, Safaa, Agha, Hala Mounir, El-Kholy, Amani, Abdellatif-Daboor, Mohammad, Dursun, Oguz, Okulu, Emel, Havan, Merve, Yildizdas, Dincer, Deniz, Suna Secil Ozturk, Guclu, Ertugrul, Hlinkova, Sona, Ikram, Aamer, Tao, Lili, Omar, Abeer Aly, Elahi, Naheed, Memish, Ziad A., Petrov, Michael M., Raka, Lul, Janc, Jarosław, Horhat-Florin, George, Medeiros, Eduardo Alexandrino, Salgado, Estuardo, Dueñas, Lourdes, Coloma, Monica, Perez, Valentina, Brown, Eric Christopher

Publicado 2024

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Background: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. Methods: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4–15 month, 16–27 month, and 28–39 month periods. Results: 174,987 patients, during 1,201,592 patient-days, used 463,592 MV-days. VAP per 1000 MV-days rates decreased from 28.46 at baseline to 17.58 at the 2nd month (RR = 0.61; 95% CI = 0.58–0.65; P < 0.001); 13.97 at the 3rd month (RR = 0.49; 95% CI = 0.46–0.52; P < 0.001); 14.44 at the 4–15 month (RR = 0.51; 95% CI = 0.48–0.53; P ...