Related Experiment Video
Updated: Sep 26, 2025
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Improving management of ventilator associated tracheitis in a level IV NICU
Ellen C Ingolfsland1, Juan David Gonzalez-Villamizar2, Jeanne Moore3
1University of Minnesota Medical School, Minneapolis, MN, United States. eingolf@umn.edu.
Background:
There are no published guidelines regarding the diagnosis and treatment of ventilator-associated tracheitis (VAT) in the neonatal intensive care unit (NICU). VAT is likely over-diagnosed and over-treated, increasing antibiotic burden and cost.
Local Problem:
Diagnosis and treatment of VAT were entirely NICU provider dependent.
Methods:
Retrospective pre- and post-intervention chart reviews were performed.
Interventions:
A VAT diagnosis and treatment algorithm was created for use in the care of intubated patients without tracheostomies. 3 plan-do-study-act (PDSA) cycles were used to implement change.
Results:
Intubated patients treated for VAT with <25 PMNs on Gram stain decreased from 79% to 35% following the quality improvement (QI) initiative. Treatment of VAT with >7 days of antibiotic therapy decreased from 42% to 10%.
Conclusion:
Implementing a QI initiative to improve the diagnosis and treatment of VAT in the NICU decreased the percent of patients treated inappropriately for VAT.
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