Repositioning of endotracheal tube and risk of ventilator-associated pneumonia among adult patients: A matched case-control study
INTRODUCTION: Ventilator-associated pneumonia (VAP) is one of the most serious hospital-acquired infections to occur among mechanically ventilated patients. Many risk factors for VAP have been identified in the literature; however, there is a lack of studies examining the association between endotra...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Annals of Thoracic Medicine |
| Subjects: | |
| Online Access: | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2019;volume=14;issue=4;spage=264;epage=268;aulast=Ismaeil |
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| author | Taha Ismaeil Latifah Alfunaysan Nouf Alotaibi Shatha Alkadi Fatmah Othman |
| author_facet | Taha Ismaeil Latifah Alfunaysan Nouf Alotaibi Shatha Alkadi Fatmah Othman |
| author_sort | Taha Ismaeil |
| collection | DOAJ |
| description | INTRODUCTION: Ventilator-associated pneumonia (VAP) is one of the most serious hospital-acquired infections to occur among mechanically ventilated patients. Many risk factors for VAP have been identified in the literature; however, there is a lack of studies examining the association between endotracheal tube (ETT) repositioning and an increase in the risk of VAP. The aim of the present study, therefore, was to investigate the effect of ETT repositioning and the risk of developing VAP.
METHODS: Matched case-control studies were conducted among mechanically ventilated patients admitted to the intensive care unit (ICU) at King Abdulaziz Medical City from 2016 to 2018. Patients who had a documented VAP diagnosis were identified and matched to four controls (within a 10-year age band). The history of ETT repositioning (defined as changes in the positioned ETTs from the first reading at the time of ETT insertion) was explored in the medical files of the sample, as were other demographic and comorbidity risk factors. Logistic regression analysis was used to test the association between ETT repositioning and VAP.
RESULTS: A total of 24 cases were identified with documented VAP diagnosis during the study. Those cases were matched to 81 controls. The mean age was 55 (standard deviation 21) for both cases and controls. VAP patients had a greater history of ETT repositioning (46%) compared to controls (29%). Patients who had a history of ETT repositioning were twice as likely to develop VAP as patients who had no history of ETT repositioning (P = 0.13). After adjustment of a potential confounder, the results showed evidence of an increased risk of VAP after ETT repositioning (odds ratio 3.1, 95% confidence interval 1.0–9.6).
CONCLUSION: Reposition of ETT considers as a risk factor for VAP in ICU patients, and appropriate measures should be applied to reduce movements of the ETT tube. |
| first_indexed | 2024-04-12T03:09:38Z |
| format | Article |
| id | doaj.art-94db762f947049609b0eddfde6e04fb2 |
| institution | Directory Open Access Journal |
| issn | 1817-1737 1998-3557 |
| language | English |
| last_indexed | 2024-04-12T03:09:38Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Thoracic Medicine |
| spelling | doaj.art-94db762f947049609b0eddfde6e04fb22022-12-22T03:50:23ZengWolters Kluwer Medknow PublicationsAnnals of Thoracic Medicine1817-17371998-35572019-01-0114426426810.4103/atm.ATM_26_19Repositioning of endotracheal tube and risk of ventilator-associated pneumonia among adult patients: A matched case-control studyTaha IsmaeilLatifah AlfunaysanNouf AlotaibiShatha AlkadiFatmah OthmanINTRODUCTION: Ventilator-associated pneumonia (VAP) is one of the most serious hospital-acquired infections to occur among mechanically ventilated patients. Many risk factors for VAP have been identified in the literature; however, there is a lack of studies examining the association between endotracheal tube (ETT) repositioning and an increase in the risk of VAP. The aim of the present study, therefore, was to investigate the effect of ETT repositioning and the risk of developing VAP. METHODS: Matched case-control studies were conducted among mechanically ventilated patients admitted to the intensive care unit (ICU) at King Abdulaziz Medical City from 2016 to 2018. Patients who had a documented VAP diagnosis were identified and matched to four controls (within a 10-year age band). The history of ETT repositioning (defined as changes in the positioned ETTs from the first reading at the time of ETT insertion) was explored in the medical files of the sample, as were other demographic and comorbidity risk factors. Logistic regression analysis was used to test the association between ETT repositioning and VAP. RESULTS: A total of 24 cases were identified with documented VAP diagnosis during the study. Those cases were matched to 81 controls. The mean age was 55 (standard deviation 21) for both cases and controls. VAP patients had a greater history of ETT repositioning (46%) compared to controls (29%). Patients who had a history of ETT repositioning were twice as likely to develop VAP as patients who had no history of ETT repositioning (P = 0.13). After adjustment of a potential confounder, the results showed evidence of an increased risk of VAP after ETT repositioning (odds ratio 3.1, 95% confidence interval 1.0–9.6). CONCLUSION: Reposition of ETT considers as a risk factor for VAP in ICU patients, and appropriate measures should be applied to reduce movements of the ETT tube.http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2019;volume=14;issue=4;spage=264;epage=268;aulast=IsmaeilEndotracheal tubemechanical ventilationventilator-associated pneumonia |
| spellingShingle | Taha Ismaeil Latifah Alfunaysan Nouf Alotaibi Shatha Alkadi Fatmah Othman Repositioning of endotracheal tube and risk of ventilator-associated pneumonia among adult patients: A matched case-control study Annals of Thoracic Medicine Endotracheal tube mechanical ventilation ventilator-associated pneumonia |
| title | Repositioning of endotracheal tube and risk of ventilator-associated pneumonia among adult patients: A matched case-control study |
| title_full | Repositioning of endotracheal tube and risk of ventilator-associated pneumonia among adult patients: A matched case-control study |
| title_fullStr | Repositioning of endotracheal tube and risk of ventilator-associated pneumonia among adult patients: A matched case-control study |
| title_full_unstemmed | Repositioning of endotracheal tube and risk of ventilator-associated pneumonia among adult patients: A matched case-control study |
| title_short | Repositioning of endotracheal tube and risk of ventilator-associated pneumonia among adult patients: A matched case-control study |
| title_sort | repositioning of endotracheal tube and risk of ventilator associated pneumonia among adult patients a matched case control study |
| topic | Endotracheal tube mechanical ventilation ventilator-associated pneumonia |
| url | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2019;volume=14;issue=4;spage=264;epage=268;aulast=Ismaeil |
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