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Multidisciplinary quality improvement initiative to reduce ventilator-associated tracheobronchitis in the PICU

Jennifer A Muszynski1, James Sartori, Lisa Steele

  • 1Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA. jennifer.muszynski@nationwidechildrens.org

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|May 1, 2013
PubMed

Insights

Implementing a care bundle significantly reduced ventilator-associated tracheobronchitis in a pediatric ICU. This intervention improved patient outcomes, decreasing the incidence of this serious respiratory infection.

Area of Science:

  • Critical Care Medicine
  • Infectious Disease Prevention
  • Pediatric Hospital Epidemiology

Background:

  • Nosocomial airway infections, including ventilator-associated tracheobronchitis (VAT), pose significant risks to pediatric intensive care unit (PICU) patients.
  • Effective strategies are needed to reduce the incidence of VAT and improve patient outcomes.

Purpose of the Study:

  • To evaluate the impact of a care bundle on the incidence of ventilator-associated tracheobronchitis in a PICU.
  • To determine if VAT is associated with adverse patient outcomes.

Main Methods:

  • A prospective, pre- and post-interventional study was conducted in a PICU.
  • Patients requiring invasive mechanical ventilation for ≥48 hours were included.
  • A multidisciplinary, unit-wide care bundle was implemented to prevent ventilator-associated airway infections.

Main Results:

  • The incidence of VAT decreased from 3.9 to 1.8 cases per 1,000 ventilator days post-intervention (p=0.04).
  • Patients with VAT experienced significantly fewer ventilator-free and ICU-free days.
  • These associations remained significant after multivariable regression analysis.

Conclusions:

  • Successful implementation of the care bundle led to a significant reduction in VAT incidence.
  • VAT independently correlated with poorer outcomes, including prolonged mechanical ventilation and ICU stay.
  • The findings support the use of care bundles to prevent VAT in pediatric ICUs.
Abstract

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