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Are periodic changes of ventilator circuits necessary?

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Objective

To analyze the utility of periodic change of ventilator circuits (PCVC) to prevent the incidence of pneumonia (PN), tracheobronchitis (TB) and tracheal colonization (TC) in patients undergoing mechanical ventilation.

Methods

From 1 April 2001 until 30 August 2001 a prospective and randomized study was realized. Included were all patients admitted in ICU and who required mechanical ventilation for 72 hours or more. At admission to the ICU patients were randomized in two groups: one group ventilated with PCVC each 48 hours, and another one without change. A throat swab on admission and afterwards twice weekly were taken. Infections were diagnosed according to CDC criteria and classified based on throat flora in endogenous and exogenous. The statistical analysis was realized by chi-square test and Student t-test, and we took values P < 0.05 to consider a significant difference.

Results

Included were 87 patients (62.06% male). Mean age was 59.52 ± 18.23 years. APACHE-II was 16.01 ± 6.24. Mortality was 18.39%. Both groups of patients (39 with PCVC and 48 without change) were similar in age, sex, mortality and APACHE-II. No significant differences were found in the percentage of patients who developed some infectious events (PN 20.68%, PN or TB 31.03%, PN or TB or TC 48.27%), nor in the number of infectious events per 1000 mechanical ventilation-days (PN 12.42, PN or TB 21.92, PN or TB or TC 37.28). Neither in the the percentage of patients who developed infectious events and in the number of infectious events per 1000 mechanical ventilation-days in each group of mechanical ventilation-days. Neither in the number of exogenous events per 1000 mechanical ventilation-days (PN 2.92, PN or TB 4.38, PN or TB or TC 6.57).

Conclusions

The periodic change of ventilator circuits do not reduce the incidence of respiratory infections, neither exogenous events. This may be an unnecessary practice.

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Lorente, L., Lecuona, M., Galván, R. et al. Are periodic changes of ventilator circuits necessary?. Crit Care 6, P32 (2002). https://doi.org/10.1186/cc1731

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Keywords

  • Public Health
  • Pneumonia
  • Mechanical Ventilation
  • Emergency Medicine
  • Respiratory Infection