Journal of Critical Care
Volume 25, Issue 1 , Pages 56-61 , March 2010

Effect of frequency of ventilator circuit changes (3 vs 7 days) on the rate of ventilator-associated pneumonia in PICU

  • Rujipat Samransamruajkit, MD

      Affiliations

    • Division of Pediatric Pulmonary and Critical Care, Department of Pediatrics, Chulalongkorn University, Bangkok 10330, Thailand
    • Corresponding Author InformationCorresponding author. Tel.: +66 2 256-4996x129, 123; fax: +66 2 256-4911.
    • ,
  • Suree Jirapaiboonsuk, MD

      Affiliations

    • Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
    • ,
  • Sirirush Siritantiwat

      Affiliations

    • Registered Critical Care Nurse, Chulalongkorn University, Bangkok 10330, Thailand
    • ,
  • Ornanong Tungsrijitdee

      Affiliations

    • Registered Critical Care Nurse, Chulalongkorn University, Bangkok 10330, Thailand
    • ,
  • Jitladda Deerojanawong

      Affiliations

    • Division of Pediatric Pulmonary and Critical Care, Department of Pediatrics, Chulalongkorn University, Bangkok 10330, Thailand
    • Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
    • ,
  • Suchada Sritippayawan

      Affiliations

    • Division of Pediatric Pulmonary and Critical Care, Department of Pediatrics, Chulalongkorn University, Bangkok 10330, Thailand
    • Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
    • ,
  • Nuanchan Prapphal

      Affiliations

    • Division of Pediatric Pulmonary and Critical Care, Department of Pediatrics, Chulalongkorn University, Bangkok 10330, Thailand
    • Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand

References 

  1. Safdar N, Dezfulian C, Collard H, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med. 2005;33(10):2184–2193
  2. Kollef M. The prevention of ventilator-associated pneumonia. N Engl J Med. 1999;340:627–634
  3. Nieuwenhoven V, Buskens E, Bergmans D, et al. Oral decontamination is cost-saving in the prevention of ventilator-associated pneumonia. Crit Care Med. 2004;32(1):126–130
  4. Edwards J, Peterson K, Andrus M, et al. National Health Care safety Network (NHSN) report, data summary for 2006. Am J Infect Control. 2007;35:290–301
  5. Elwards A, Warren D, Fraser V. Ventilator-associated pneumonia in PICU patients; risk factors and outcomes. Pediatrics. 2002;109:758–764
  6. Almuneef M, Memish Z, Balkhy H, et al. Ventilator associated pneumonia in a PICU in Saudi Arabia: a 30-month prospective surveillance. Infect Control Hosp Epidemiol. 2004;25:753–757
  7. Craven D, Goularte T, Make B. Contaminated condensates in mechanical ventilator circuits: a risk factor for nosocomial pneumonia?. Am Rev Respir Dis. 1984;129:625–628
  8. Flournoy D, Plumlee C, Steffee R. Volume ventilator as a vehicle of airborne bacterial contamination from patients. Respir Care. 1980;25:742–744
  9. Fink JB, Krause SA, Barrett L, et al. Extending ventilator circuit change interval beyond 2 days reduces the likelihood of ventilator-associated pneumonia. Chest. 1998;113(2):405–411
  10. Long MN, Wickstrom G, Grimes A, Benton CE, Belcher B, Stamm AM. Prospective, randomized study of ventilator-associated pneumonia in patients with one versus three ventilator circuit changes per week. Infect Control Hosp Epidemiol. 1996;17(1):14–19
  11. CDC . Outline for health care-associated infection surveillance. 2007;
  12. Branson R. The ventilator circuit and ventilator associated pneumonia. Respir Care. 2005;50:774–787
  13. Malecka-Griggs B. Microbiological assessment of 24 and 48 hrs changes and management of semiclosed circuits from ventilators in a neonatal intensive care unit. J Clin Microbiol. 1986;23:322–328
  14. Dreyfuss D, Djedaini K, Weber P, et al. Prospective study of nosocomial pneumonia and circuit colonization during mechanical ventilation with circuit change every 48 hrs versus no change. Am Rev Respir Dis. 1991;143:738–743
  15. Gastmeier P, Wendt C, Ruden H. Exchange of breathing circuits in intensive care: once a day or once a week?. Anaesthesist. 1997;46(11):943–948
  16. Makhoul IR, Kassis I, Berant M, et al. Frequency of changes of ventilator circuit in premature infants: impact on ventilator-associated pneumonia. Pediatr Crit Care Med. 2001;2:127–132
  17. Hess D, Burns E, Romagnoli D, Kacmarek R. Weekly ventilator circuit changes: a strategy to reduce costs without affecting pneumonia rates. Anesthesiology. 1995;85:903–911
  18. Kotilainen H, Keroack M. Cost analysis and clinical impact of weekly ventilator circuit changes in patients in intensive care unit. Am J Infect Control. 1997;25:117–120
  19. Lien T, Lin M, Chu C, et al. Ventilator associated pneumonia with circuit change every 2 days versus every week. Zhonghua Yi Xue Za Zhi(Taipei). 2001;64:161–167
  20. Han J, Liu Y, Ma S, et al. Effects of decreasing the frequency of ventilator circuit change to every 7 days on the rate of ventilator associated pneumonia in a Beijing hospital. Respir Care. 2001;46:891–896
  21. Safdar N, Crnich C, Maki DG. The pathogenesis of VAP: its relevance to developing effective strategies for prevention. Respir Care. 2005;50(6):725–729

PII: S0883-9441(09)00075-6

doi: 10.1016/j.jcrc.2009.03.005

Journal of Critical Care
Volume 25, Issue 1 , Pages 56-61 , March 2010

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