Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel

The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative.

Publication ,  Journal Article
Klompas, M; Anderson, D; Trick, W; Babcock, H; Kerlin, MP; Li, L; Sinkowitz-Cochran, R; Ely, EW; Jernigan, J; Magill, S; Lyles, R; O'Neil, C ...
Published in: Am J Respir Crit Care Med
February 1, 2015

RATIONALE: The CDC introduced ventilator-associated event (VAE) definitions in January 2013. Little is known about VAE prevention. We hypothesized that daily, coordinated spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs) might prevent VAEs. OBJECTIVES: To assess the preventability of VAEs. METHODS: We nested a multicenter quality improvement collaborative within a prospective study of VAE surveillance among 20 intensive care units between November 2011 and May 2013. Twelve units joined the collaborative and implemented an opt-out protocol for nurses and respiratory therapists to perform paired daily SATs and SBTs. The remaining eight units conducted surveillance alone. We measured temporal trends in VAEs using generalized mixed effects regression models adjusted for patient-level unit, age, sex, reason for intubation, Sequential Organ Failure Assessment score, and comorbidity index. MEASUREMENTS AND MAIN RESULTS: We tracked 5,164 consecutive episodes of mechanical ventilation: 3,425 in collaborative units and 1,739 in surveillance-only units. Within collaborative units, significant increases in SATs, SBTs, and percentage of SBTs performed without sedation were mirrored by significant decreases in duration of mechanical ventilation and hospital length-of-stay. There was no change in VAE risk per ventilator day but significant decreases in VAE risk per episode of mechanical ventilation (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.42-0.97) and infection-related ventilator-associated complications (OR, 0.35; 95% CI, 0.17-0.71) but not pneumonias (OR, 0.51; 95% CI, 0.19-1.3). Within surveillance-only units, there were no significant changes in SAT, SBT, or VAE rates. CONCLUSIONS: Enhanced performance of paired, daily SATs and SBTs is associated with lower VAE rates. Clinical trial registered with www.clinicaltrials.gov (NCT 01583413).

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

February 1, 2015

Volume

191

Issue

3

Start / End Page

292 / 301

Location

United States

Related Subject Headings

  • Ventilator Weaning
  • United States
  • Time Factors
  • Thromboembolism
  • Risk Factors
  • Risk Assessment
  • Respiratory System
  • Respiration, Artificial
  • Pulmonary Edema
  • Pulmonary Atelectasis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Klompas, M., Anderson, D., Trick, W., Babcock, H., Kerlin, M. P., Li, L., … CDC Prevention Epicenters, . (2015). The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative. Am J Respir Crit Care Med, 191(3), 292–301. https://doi.org/10.1164/rccm.201407-1394OC
Klompas, Michael, Deverick Anderson, William Trick, Hilary Babcock, Meeta Prasad Kerlin, Lingling Li, Ronda Sinkowitz-Cochran, et al. “The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative.Am J Respir Crit Care Med 191, no. 3 (February 1, 2015): 292–301. https://doi.org/10.1164/rccm.201407-1394OC.
Klompas M, Anderson D, Trick W, Babcock H, Kerlin MP, Li L, et al. The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative. Am J Respir Crit Care Med. 2015 Feb 1;191(3):292–301.
Klompas, Michael, et al. “The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative.Am J Respir Crit Care Med, vol. 191, no. 3, Feb. 2015, pp. 292–301. Pubmed, doi:10.1164/rccm.201407-1394OC.
Klompas M, Anderson D, Trick W, Babcock H, Kerlin MP, Li L, Sinkowitz-Cochran R, Ely EW, Jernigan J, Magill S, Lyles R, O’Neil C, Kitch BT, Arrington E, Balas MC, Kleinman K, Bruce C, Lankiewicz J, Murphy MV, E Cox C, Lautenbach E, Sexton D, Fraser V, Weinstein RA, Platt R, CDC Prevention Epicenters. The preventability of ventilator-associated events. The CDC Prevention Epicenters Wake Up and Breathe Collaborative. Am J Respir Crit Care Med. 2015 Feb 1;191(3):292–301.

Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

February 1, 2015

Volume

191

Issue

3

Start / End Page

292 / 301

Location

United States

Related Subject Headings

  • Ventilator Weaning
  • United States
  • Time Factors
  • Thromboembolism
  • Risk Factors
  • Risk Assessment
  • Respiratory System
  • Respiration, Artificial
  • Pulmonary Edema
  • Pulmonary Atelectasis