Ventilator Circuit Changes
Authors: Marin H. Kollef
Journal: Annals of Internal Medicine (1996)

Letters15 May 1996Ventilator Circuit ChangesMarin H. Kollef, MD, Steven D. Shapiro, MD, and Victoria J. Fraser, MDMarin H. Kollef, MDWashington University School of Medicine; St. Louis, MO 63110Search for more papers by this author, Steven D. Shapiro, MDWashington University School of Medicine; St. Louis, MO 63110Search for more papers by this author, and Victoria J. Fraser, MDWashington University School of Medicine; St. Louis, MO 63110Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-10-199605150-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Drs. Asbel and Johnson that the use of uniform definitions for infection rates allows more accurate comparisons among medical reports. The occurrence of ventilator-associated pneumonia in our group receiving circuit changes every 7 days was 17.4 per 1000 ventilator-days. The incidence of ventilator-associated pneumonia in the group receiving no circuit changes was 16.4 infections per 1000 ventilator-days [1].We selected a 7-day circuit change schedule as the “standard of practice” for our control group on the basis of the available medical literature and our survey of 16 regional medical centers [1]. Our current understanding of ...References1. Kollef MH, Shapiro SD, Fraser MD, Silver P, Murphy DM, Trovillion E, et al. Mechanical ventilation with or without 7-day circuit changes. A randomized, controlled trial. Ann Intern Med. 1995; 123:168-74. Google Scholar2. Dreyfuss D, Djedaini K, Gros I, Mier L, Le Bourdelles G, Cohen Y, et al. Mechanical ventilation with heated humidifiers or heat and moisture exchangers: effects on patient colonization and incidence of nosocomial pneumonia. Am J Respir Crit Care Med. 1995; 151:986-92. Google Scholar3. Rello J, Ausina V, Ricart M, Castella J, Prats G. Impact of previous antimicrobial therapy on the etiology and outcome of ventilator-associated pneumonia. Chest. 1993; 104:1230-5. Google Scholar4. Torres A, el-Ebiary M, Padro L, Gonzalez J, de la Bellacasa JP, Ramirez J, et al. Validation of different techniques for the diagnosis of ventilator-associated pneumonia. Comparison with immediate postmortem pulmonary biopsy. Am J Respir Crit Care Med. 1994; 149:324-31. Google Scholar5. Niederman MS, Torres A, Summer W. Invasive diagnostic testing is not needed routinely to manage suspected ventilator-associated pneumonia. Am J Respir Crit Care Med. 1994; 150:565-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: Washington University School of Medicine; St. Louis, MO 63110 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByVentilator-associated pneumonia and frequency of circuit changes 15 May 1996Volume 124, Issue 10Page: 929-930KeywordsAntibioticsDeath ratesPathogensPatientsPneumoniaPseudomonas aeruginosaVentilator associated pneumoniaVentilators Issue Published: 15 May 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...