Comparison of ventilator-related event (VİO) and ventilator-associated pneumonia (VAP) definitions in the surveillance of ventilation-related problems in patients treated with invasive mechanical ventilator in intensive care unit with COVİD-19 pneumonia

VAP is very common in critically ill COVİD-19 patients with acute respiratory distress syndrome due to prolonged invasive mechanical ventilation. The complication of VAP; significantly affects the success of treatment. There is currently no valid definition for VAP and most widely used VAP criteria and definitions are neither sensitive nor specific. Various surveillance criteria and algorithms have been developed to determine VAP rates and to establish VAP prevention strategies. The aim of this study is to compare the effectiveness of traditional and new surveillance definitions in the determination of mechanical ventilator related complications in patients receiving IMV therapy with COVID-19 pneumonia and to determine clinical characteristics of the patients with VAP and VAE. In addition, to investigate the relationship between VAP and VAE with mortality and other clinical outcomes. In this study, 77 patients who received IMV therapy longer than forty-eight hours in Hacettepe University Department of Internal Medicine, COVID-19 ICU were evaluated with VAP and VAE active surveillance during one year study period. VAP was detected in 33 (42.8%) patients according to traditional PNEU/VAP criteria. The incidence of VAP was found 13.55 per 1000 ventilator days. The median length of IMV stay was found 22 (10-48) days in patients who developed VAP. This period was shorter, median 12 (3-77) days in patients who did not develop VAP (p<0.001). During the follow up VAE developed in 15 (% 19.5) patients. The incidence of VAE was found 6.16 per 1000 ventilator days. VIO was also diagnosed in 11 (33%) of 33 patients who developed VAP. In our study, the findings showed that the definition of VIO in COVID-19 patients did not have a strong relationship with VAP. VAP recognizes ventilator-associated secondary bacterial infections at a higher rate and earlier in critically ill patients with COVID-19 pneumonia. Key words: COVID 19, surveillance, ventilator associated event, pneumonia