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Table 1 Characteristics of studies included in the meta-analysis

From: Does ventilator-associated event surveillance detect ventilator-associated pneumonia in intensive care units? A systematic review and meta-analysis

Reference

Region

Units (n)

ICU type

Baseline period

Population

VAE criteria

VAP criteria

Design

Sample size

Adjusted confounders

Total (n)

VAE

VAP

[17]a

USA

7

MICU, SICU, CICU

2011.11–2013.05

Consecutive mechanical ventilation episodes from collaborative units undergoing daily SAT/SBT

CDC/NHSN definition

NA

Interrupted time series analysis

3425

293

NA

Age, sex, reason for intubation, and SOFA score

[17]b

USA

6

MICU, SICU, CICU

2011.11–2013.05

Consecutive mechanical ventilation episodes from surveillance-only units not undergoing daily SAT/SBT

CDC/NHSN definition

NA

Interrupted time series analysis

1739

75

NA

Age, sex, reason for intubation, and SOFA score

[18]a

Belgium

1

ICU

2012.01–2013.03

Adult patients ventilated for ≥2 calendar days from groups undergoing subglottic secretion suctioning

CDC/NHSN definition

CDC/NHSN criteria and quantitative culture results of specimens

Randomized controlled trial

170

37

15

NA

[18]b

Belgium

1

ICU

2012.01–2013.03

Adult patients ventilated for ≥2 calendar days from groups not undergoing subglottic secretion suctioning

CDC/NHSN definition

CDC/NHSN criteria and quantitative culture results of specimens

Randomized controlled trial

182

41

32

NA

[19]

China

1

ICU

2010.04–2014.02

VAP patients

CDC/NHSN definition

CDC/NHSN criteria

Retrospective cohort

165

55

165

NA

[20]

USA

1

SICU, MICU

2013.01–2013.12

Adult patients ventilated for ≥2 calendar days

CDC/NHSN definition

CDC/NHSN criteria and quantitative culture of specimens

Prospective cohort

1209

67

84

NA

[21]

France

Multiple centres

ICU

1996.11–2012.10

Adult patients ventilated for ≥5 calendar days from French multicentre OUTCOMEREA database

Adapted definition (≥2 day rise in range of PEEP or a decreasing PaO2/FiO2 ratio by >50 mm Hg with the same level of PEEP or by >100 mm Hg whatever the level of PEEP)

CDC/NHSN criteria

Inception cohort

3028

2331

816

NA

[22]

USA

1

MICU

2012.12–2013.04

Adult patients requiring mechanical ventilation

CDC/NHSN definition

NA

Retrospective cohort

257

19

NA

NA

[23]

USA

1

SICU

2012.09–2013.08

All intubated patients admitted to SICU

CDC/NHSN definition

Criteria based on clinical pulmonary infection score (CPIS) and quantitative culture of specimens

Prospective screening test

704

37

121

NA

[24]

USA

1

MICU, SICU

2008.07–2013.03

Adult patients ventilated for ≥4 calendar days continuously

CDC/NHSN definition

CDC/NHSN criteria

Retrospective cohort

3302

675

30c

Race, comorbidities, emergent admissions

[25]

USA

1

MICU, SICU, CICU, Neuro-ICU

2009.01–2012.04

Adult patients who were managed with mechanical ventilation

CDC/NHSN definition

CDC/NHSN criteria

Prospective cohort

8408

387

83

APACHE score, type of ICU

[26]

England

1

MICU, SICU,CICU, Neuro-ICU

2011.01–2011.12

Patients on mechanical ventilation in ICU

CDC/NHSN definition

NA

Retrospective nested case–control

2990

172

NA

Age, sex, ICU type, Charlson score, and time to VAC onset

[27]

Netherland

2

ICU

2011.01–2012.07

Adult patients who had received ≥2 consecutive days of mechanical ventilation

CDC/NHSN definition

CDC/NHSN criteria and quantitative culture of specimens

Prospective cohort

2080

152

3

Age, sex, APACHE score, admission type, and hospital

[28]

England

1

ICU

2006.07–2013.12

All episodes of invasive mechanical ventilation lasting ≥3 calendar days

CDC/NHSN definition

NA

Retrospective cohort

9603

1308

NA

Age, race, sex, calendar year, ICU type, comorbidities, initial laboratory values, medications, procedures

[29]

England

1

MICU, SICU, CICU, Neuro-ICU

2006.01–2011.12

Adult patients initiated on mechanical ventilation

CDC/NHSN definition

NA

Retrospective cohort

20356

1056

NA

Age, sex, unit type, Charlson score, use of vasopressors on the day of intubation, platelet count, total bilirubin, albumin, creatinine, and alanine aminotransferase level

[30]

Canada

1

ICU

2011.07–2012.09

VAP patients received at least 72 h broad-spectrum antimicrobials

CDC/NHSN definition

CDC/NHSN criteria

Retrospective cohort

81

45

81

NA

[31]

Canada, USA

11

MICU, SICU, Trauma ICU

2007.06–2009.12

Adult patients who met the inclusion criteria of age ≥16 years and who were mechanically ventilated for ≥48 h

CDC/NHSN definition

CDC/NHSN criteria

Interrupted time series analysis

1320

139

148

NA

[32]

Australia

1

MICU, SICU

2009.05–2011.01

All patients aged >18 years who were on mechanical ventilation for >48 h

Adapted definition (increases in FiO2 by ≥15 % or PEEP by ≥2.5 cm H2O lasting ≥2 days after stable or decreasing FiO2 or PEEP lasting ≥ 2 days.)

NA

Retrospective cohort

1657

153

NA

NA

[33]

USA

3

MICU, SICU

2006–2007

All patients aged >18 years who were on mechanical ventilation for >48 h

Adapted definition (increases in FiO2 by ≥15 % or positive end-expiratory pressure (PEEP) by ≥2.5 cm H2O lasting ≥2 days after stable or decreasing FiO2 or PEEP lasting ≥ 2 days.)

CDC/NHSN criteria

Retrospective nested case–control

597

135

55

Age, sex, hospital, unit type, and Charlson comorbidity index

[34]

USA

1

ICU

2009.07–2013.12

Patients at least 18 years old, admitted to the ICU after trauma, required endotracheal intubation and mechanical ventilator support for at least 48 h, and received a minimum of 1 unit of packed red blood cell transfusion during their mechanical ventilator support

CDC/NHSN definition

CDC/NHSN criteria

Retrospective cohort

216

31

64

NA

  1. a,bStudy that ​comprised 2 separate groups within one article. cPatients with ventilator-associated pneumonia (VAP) were limited to four ICUs among all nine ICUs in the included study. NHSN National Healthcare Safety Network, MICU medical intensive care unit, SICU surgical intensive care unit, CICU cardiac intensive care unit, VAP ventilator-associated pneumonia, VAE ventilator-associated events (including ventilator-associated conditions (VAC), infection-related VAC (IVAC), possible VAP, and probable VAP), SAT/SBT spontaneous awakening trials/spontaneous breathing trials, PEEP positive end-expiratory pressure, FiO 2 fraction of inspired oxygen, CDC Centers for Disease Control, NHSN National Healthcare Safety Network, SOFA sequential organ failure assessment, PaO 2 partial pressure of oxygen, NA not available