Determining the ideal strategy for ventilator-associated pneumonia prevention: Cost-benefit analysis

American Journal of Respiratory and Critical Care Medicine

Volumn 192, Issue 1, 2015, Pages 57-63

  Branch Elliman, Westyn ^a   Wright, Sharon B ^b   Howell, Michael D ^c  

^a UNIVERSITY OF COLORADO SCHOOL OF MEDICINE   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

^c UNIVERSITY OF CHICAGO   (United States)

Author keywords

Cost benefit analysis; Healthcare associated infection; Prevention; Ventilator associated pneumonia

Indexed keywords

CHLORHEXIDINE; PROBIOTIC AGENT; ANTIINFECTIVE AGENT;

ARTICLE; ARTIFICIAL VENTILATION; COST BENEFIT ANALYSIS; DEATH; ENDOTRACHEAL TUBE; EXTUBATION; HOSPITAL DISCHARGE; HUMAN; INTENSIVE CARE UNIT; INTUBATION; MAJOR CLINICAL STUDY; MOUTH HYGIENE; PRIORITY JOURNAL; PROBABILITY; SENSITIVITY ANALYSIS; VENTILATOR ASSOCIATED PNEUMONIA; WASTE MANAGEMENT; ANTIBIOTIC PROPHYLAXIS; DECISION TREE; ECONOMICS; ENDOTRACHEAL INTUBATION; EVALUATION STUDY; HOSPITAL COST; INFECTION CONTROL; LENGTH OF STAY; MULTIMODALITY CANCER THERAPY; PNEUMONIA, VENTILATOR-ASSOCIATED; PROCEDURES; STATISTICAL MODEL; STATISTICS AND NUMERICAL DATA; UNITED STATES;

ANTI-BACTERIAL AGENTS; ANTIBIOTIC PROPHYLAXIS; COMBINED MODALITY THERAPY; COST-BENEFIT ANALYSIS; DECISION TREES; HOSPITAL COSTS; HUMANS; INFECTION CONTROL; INTENSIVE CARE UNITS; INTUBATION, INTRATRACHEAL; LENGTH OF STAY; MARKOV CHAINS; MODELS, ECONOMIC; PNEUMONIA, VENTILATOR-ASSOCIATED; UNITED STATES;

EID: 84937215042     PISSN: 1073449X     EISSN: 15354970     Source Type: Journal    
DOI: 10.1164/rccm.201412-2316OC     Document Type: Article

References (38)

1. Skrupky LP, McConnell K, Dallas J, Kollef MH. A comparison of ventilator-associated pneumonia rates as identified according to the National Healthcare Safety Network and American College of Chest Physicians criteria. Crit Care Med 2012;40:281-284.
2. Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, et al.; EPIC II Group of Investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA 2009;302:2323-2329.
3. Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med 2005;33:2184-2193.
4. Restrepo MI, Anzueto A, Arroliga AC, Afessa B, Atkinson MJ, Ho NJ, Schinner R, Bracken RL, Kollef MH. Economic burden of ventilator-associated pneumonia based on total resource utilization. Infect Control Hosp Epidemiol 2010;31:509-515.
5. Kollef MH, Hamilton CW, Ernst FR. Economic impact of ventilator-associated pneumonia in a large matched cohort. Infect Control Hosp Epidemiol 2012;33:250-256.
6. Institute for Healthcare Improvement. Implement the IHI ventilator bundle; 2014 [accessed 2014 Apr 3]. Available from: http://www.ihi.org/resources/Pages/Changes/ImplementtheVentilatorBundle.aspx
7. Shi Z, Xie H, Wang P, Zhang Q, Wu Y, Chen E, Ng L, Worthington HV, Needleman I, Furness S. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database Syst Rev 2013;8:CD008367.
8. Richards D. Oral hygiene regimes for mechanically ventilated patients that use chlorhexidine reduce ventilator-associated pneumonia. Evid Based Dent 2013;14:91-92.
9. Gujadhur R, Helme BW, Sanni A, Dunning J. Continuous subglottic suction is effective for prevention of ventilator associated pneumonia. Interact Cardiovasc Thorac Surg 2005;4:110-115.
10. Muscedere J, Rewa O, McKechnie K, Jiang X, Laporta D, Heyland DK. Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis. Crit Care Med 2011;39:1985-1991.
11. Kollef MH, Skubas NJ, Sundt TM. A randomized clinical trial of continuous aspiration of subglottic secretions in cardiac surgery patients. Chest 1999;116:1339-1346.
12. Kollef MH, Afessa B, Anzueto A, Veremakis C, Kerr KM, Margolis BD, Craven DE, Roberts PR, Arroliga AC, Hubmayr RD, et al.; NASCENT Investigation Group. Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: the NASCENT randomized trial. JAMA 2008;300:805-813.
13. Morrow LE, Kollef MH, Casale TB. Probiotic prophylaxis of ventilator-associated pneumonia: a blinded, randomized, controlled trial. Am J Respir Crit Care Med 2010;182:1058-1064.
14. Siempos II, Ntaidou TK, Falagas ME. Impact of the administration of probiotics on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials. Crit Care Med 2010; 38:954-962.
15. de Smet AM, Kluytmans JA, Cooper BS, Mascini EM, Benus RF, van der Werf TS, van der Hoeven JG, Pickkers P, Bogaers-Hofman D, van der Meer NJ, et al. Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 2009;360:20-31.
16. Berenholtz SM, Pham JC, Thompson DA, Needham DM, Lubomski LH, Hyzy RC, Welsh R, Cosgrove SE, Sexton JB, Colantuoni E, et al. Collaborative cohort study of an intervention to reduce ventilatorassociated pneumonia in the intensive care unit. Infect Control Hosp Epidemiol 2011;32:305-314.
17. Klompas M, Khan Y, Kleinman K, Evans RS, Lloyd JF, Stevenson K, Samore M, Platt R; CDC Prevention Epicenters Program. Multicenter evaluation of a novel surveillance paradigm for complications of mechanical ventilation. PLoS One 2011;6:e18062.
18. Klompas M, Branson R, Eichenwald EC, Greene LR, Howell MD, Lee G, Magill SS, Maragakis LL, Priebe GP, Speck K, et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 2014;35:915-936.
19. Zilberberg MD, Shorr AF. Ventilator-associated pneumonia as a model for approaching cost-effectiveness and infection prevention in the ICU. Curr Opin Infect Dis 2011;24:385-389.
20. Branch-Elliman W, Wright SB, Howell MD. Reducing ventilator-associated pneumonia by optimizing infection prevention: a comparative effectiveness trial. Presented at the 49th Annual Meeting of the Infectious Diseases Society of America. October 20-23, 2011, Boston, MA.
21. Esteban A, Anzueto A, Frutos F, Alía I, Brochard L, Stewart TE, Benito S, Epstein SK, Apezteguía C, Nightingale P, et al.; Mechanical Ventilation International Study Group. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 2002;287:345-355.
22. US Department of Labor Statistics. Occupational outlook handbook: registered nurses. January 8, 2014 [accessed 2014 Nov 24]. Available from: http://www.bls.gov/ooh/healthcare/registered-nurses.htm
23. Pharmacy red book. Truven Health Analytics [updated 2014; accessed 2014 Nov 24]. Available from: http://micromedex.com/redbook
24. Branch-Elliman W, Wright SB, Gillis JM, Howell MD. Estimated nursing workload for the implementation of ventilator bundles. BMJ Qual Saf 2013;22:357-361.
25. Suys E, Nieboer K, Stiers W, De Regt J, Huyghens L, Spapen H. Intermittent subglottic secretion drainage may cause tracheal damage in patients with few oropharyngeal secretions. Intensive Crit Care Nurs 2013;29:317-320.
26. Berra L, De Marchi L, Panigada M, Yu ZX, Baccarelli A, Kolobow T. Evaluation of continuous aspiration of subglottic secretion in an in vivo study. Crit Care Med 2004;32:2071-2078.
27. Wang J, Liu KX, Ariani F, Tao LL, Zhang J, Qu JM. Probiotics for preventing ventilator-associated pneumonia: a systematic review and meta-analysis of high-quality randomized controlled trials. PLoS One 2013;8:e83934.
28. Theodorakopoulou M, Perros E, Giamarellos-Bourboulis EJ, Dimopoulos G. Controversies in the management of the critically ill: the role of probiotics. Int J Antimicrob Agents 2013;42:S41-S44.
29. Siempos II, Ntaidou TK. Probiotics for prevention of ventilator-associated pneumonia. Chest 2013;143:1185-1186.
30. Snydman DR. The safety of probiotics. Clin Infect Dis 2008;46(Suppl 2): S104-S111; discussion S144-S151.
31. Pattani R, Palda VA, Hwang SW, Shah PS. Probiotics for the prevention of antibiotic-associated diarrhea and Clostridium difficile infection among hospitalized patients: systematic review and meta-analysis. Open Med 2013;7:e56-e67.
32. Gold H, Peleg AY. Decontamination of the digestive tract in ICU patients. N Engl J Med 2009;360:2139; author reply 2140-2131.
33. Perencevich EN, Stone PW, Wright SB, Carmeli Y, Fisman DN, Cosgrove SE. Raising standards while watching the bottom line: making a business case for infection control. Infect Control Hosp Epidemiol 2007;28:1121-1133.
34. Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB. Recommendations of the panel on cost-effectiveness in health and medicine. JAMA 1996;276:1253-1258.
35. Russell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC; Panel on Cost-Effectiveness in Health and Medicine. The role of cost-effectiveness analysis in health and medicine. JAMA 1996;276: 1172-1177.
36. Hamel MB, Phillips RS, Davis RB, Teno J, Connors AF, Desbiens N, Lynn J, Dawson NV, Fulkerson W, Tsevat J. Outcomes and cost-effectiveness of ventilator support and aggressive care for patients with acute respiratory failure due to pneumonia or acute respiratory distress syndrome. Am J Med 2000;109:614-620.
37. Stevens JP, Kachniarz B, Wright SB, Gillis J, Talmor D, Clardy P, Howell MD. When policy gets it right: variability in U.S. Hospitals' diagnosis of ventilator-associated pneumonia∗. Crit Care Med 2014; 42:497-503.
38. Garland A, Olafson K, Ramsey CD, Yogendran M, Fransoo R. A population-based observational study of intensive care unit-related outcomes. With emphasis on post-hospital outcomes. Ann Am Thorac Soc 2015;12:202-208.