Ventilator-associated events surveillance: a patient safety opportunity

The Centers for Disease Control and Prevention recently released new surveillance definitions for ventilator-associated events. The new definitions broaden the focus of surveillance from ventilator-associated pneumonia alone to all significant complications of mechanical ventilation. This review will consider the rationale for the new definitions, the studies supporting their development, and their potential benefits for hospital safety programs.

Objective, automatable surveillance definitions for ventilator-associated events predicated upon sustained deteriorations in ventilator settings after a period of stable or improving settings consistently predict prolonged mechanical ventilation and higher hospital mortality risk. Qualitative analyses suggest that most events are attributable to pneumonia, pulmonary edema, atelectasis, or acute respiratory distress syndrome. One retrospective analysis suggests that improved care can decrease event rates.

Ventilator-associated event surveillance is a promising strategy to improve care for ventilated patients by providing hospitals with a broader picture of their true burden of morbid complications and an objective metric to measure the impact of care improvement initiatives. Prospective studies are now needed to define the best strategies to prevent ventilator-associated events and to quantify the extent to which they are preventable.