Evaluation of ventilator-associated pneumonia and ventilator-related event diagnoses in terms of the new national surveillance approach

Ventilator-associated pneumonia (VAP) is a frequent complication that leads to increased mortality, morbidity and healthcare costs in patients receiving respiratory failure and ventilator support. Diagnosing VAP is problematic because there is no ideal diagnostic criterion. The case definitions used in the surveillance of healthcare related infections were updated in 2013 by "Centers for Disease Control and Prevention (CDC)". One of the most important of these updates includes innovations related to the definition of ventilator-associated pneumonia (VAP). Regarding VAP cases which have been reported with highly heterogeneous findings due to variability and relativity in the criteria of nosocomial pneumonia, which were previously included in the "National Healthcare Safety Network (NHSN)"; Lung radiology was no longer a diagnostic criterion, and oxygenation disorder, which was defined by a significant increase in its levels, became a determinant in the diagnosis. In the case definitions, under the title of "Ventilatory Associated Event (VAE)"; A new surveillance algorithm has been created by defining different clinical categories such as "Ventilatory Associated Event (VAE)", "Infection related ventilator-associated complication (IVAC)", "probable VAP" and "high probable VAP". It has been used in our country since 2017. In this study, the patients diagnosed with ventilator-related event diagnosed according to the new algorithm in Aydın State Hospital Anesthesia-Reanimation Intensive Care Units (ARS1, ARS2, ARS3) were investigated and the effect of the new criteria on the infection rates among these, which met the diagnosis of ventilator-related pneumonia. It was evaluated. The collected data were analyzed by using SPSS 18.0 program and statistical analyzes were made. As a result of the study, we can say the following; Theoretically, new criteria developed for not playing the system are thought-provoking because of the positive end-exituspiratory pressure (PEEP) –Positive Post-Expiratory Pressure "," Fraction of Inspired Oxygen (FiO2) -Oxygen Rate in Breathing Air "or both. Units can adjust FiO2 or PEEP in smaller increments to prevent ventilator-associated event (VAE) detection. There is no scoring, scala or algorithm to provide increases and decreases in PEEP and FiO2. Therefore, the importance of adjusting PEEP and FiO2 should be emphasized as well as determining the complications that cause oxygenation changes and not just the VIP.