Frequency, prevention, outcome, and treatment of ventilator-associated tracheobronchitis: systematic review and meta-analysis
Abstract number: O388
Agrafiotis M., Siempos I., Falagas M.
Objective: To clarify issues regarding the frequency, prevention, outcome, and treatment of patients with ventilator-associated tracheobronchitis (VAT), which is a lower respiratory tract infection involving the tracheobronchial tree, while sparing the lung parenchyma.
Methods: We performed a systematic review and meta-analysis of relevant available data, gathered though searches of PubMed, Scopus, and reference lists, without time restrictions. A conservative random effects model was used to calculate pooled odds ratios (OR) and 95% confidence intervals (CI).
Results: Out of the 564 initially retrieved articles, 30 papers were included. Frequency of VAT was 10.2%. Selective digestive decontamination was proved an effective preventive strategy against VAT. Presence, as opposed to the absence, of VAT was not associated with higher mortality (OR: 1.18, 95% CI 0.901.53). Administration of systemic antimicrobials (with or without inhaled ones), as opposed to placebo or no treatment, in patients with VAT was not associated with lower mortality (OR: 0.56, 95% CI 0.271.14). Most of the studies providing relevant data noted that administration of antimicrobial agents, as opposed to placebo or no treatment, in patients with VAT was associated with more ventilator-free days and lower frequency of subsequent pneumonia, but without shorter length of intensive care unit stay or shorter duration of mechanical ventilation.
Conclusions: Approximately one tenth of mechanically ventilated patients suffer from VAT; an infection potentially prevented by the implementation of selective digestive decontamination. Antimicrobial treatment of patients with VAT may protect against the development of subsequent ventilator-associated pneumonia.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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