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Ventilator-associated events in children: A review of literature

Noor Azizah Mohd Ali1, Jacqueline Jauncey-Cooke2, Fiona Bogossian3

  • 1School of Nursing, Midwifery and Social Work, The University of Queensland, Australia; Department of Critical Care Nursing, Faculty of Nursing, International Islamic University Malaysia (IIUM), Malaysia.

Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses
|December 18, 2018
PubMed

Insights

The new ventilator-associated event (VAE) surveillance definition shows promise for children but requires specific paediatric criteria. Further research is needed before clinical implementation to address challenges in VAE identification.

Area of Science:

  • Pediatric critical care medicine
  • Infectious disease surveillance
  • Respiratory care

Background:

  • Existing ventilator-associated pneumonia (VAP) definitions in children lack consistency, impacting reliable VAP identification.
  • The adult ventilator-associated event (VAE) surveillance definition was revised to address these issues.
  • Evidence for applying the VAE definition in pediatric populations is currently lacking.

Purpose of the Study:

  • To systematically review the evidence on the application of the VAE surveillance definition in children.
  • To identify potential challenges in the clinical practice of VAE surveillance in pediatric settings.

Main Methods:

  • A systematic literature search was conducted to identify relevant pediatric studies.
  • Studies were appraised using the epidemiological appraisal instrument (EAI).
  • The quality of evidence was assessed using National Health Medical Research Council (NHMRC) guidelines.

Main Results:

  • Seven studies met inclusion criteria, with above 50% quality on EAI and an overall evidence grade of C (satisfactory).
  • Pediatric VAE incidence varied widely (1.1–20.9 per 1000 ventilator days) due to differing surveillance criteria.
  • Limited agreement exists between VAE and VAP definitions in identifying VAP in children. Challenges include differing ventilation modes, inconclusive pediatric-specific criteria, and lack of automated data extraction support.

Conclusions:

  • The VAE surveillance definition shows potential for defining VAE in children, but the current evidence level is low.
  • Further consideration of pediatric-specific VAE criteria and the value of automated data collection is necessary before clinical implementation.
Abstract

Keywords:
ChildrenCriteriaIntensive care unitPaediatricSurveillanceVentilator associated event (VAE)Ventilator associated pneumonia (VAP)

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