The Science Journal of the American Association for Respiratory Care

2000 OPEN FORUM Abstracts

EFFECT OF EXTENDING CIRCUIT CHANGE INTERVALS ON VENTILATOR-ASSOCIATED PNEUMONIA RATES

Thomas Smith BS RRT, Virginia DeFilippo, MS RRT, Patricia Reagan-Cirincione, PhD, Dorothy Mazon RN MPH Yale-New Haven Hospital, New Haven, Connecticut

Background: Previous studies have suggested that changing ventilator circuits at seven-day intervals vs. the current standard of 48 hour intervals has no impact on ventilator associated pneumonia (VAP) rates. We evaluated the effect on VAP rates of changing circuits from a three time per week, Monday, Wednesday, Friday, (MWF) schedule to weekly intervals at our institution.
Method: The study was conducted in six intensive care units (ICU). The ICUs were arbitrarily divided into two groups. The Pediatric ICU, Neurosurgical ICU, and Surgical ICU were grouped and designated as Group I. Medical ICU, Coronary Care Unit, and Cardiothoracic ICU were grouped and designated as Group II. Ventilator circuits were changed every seven days for alternating two-month periods in each group. Epidemiology and Infection Control staff monitored the VAP rates for each ICU and were blinded to the circuit change frequency during the study.
During the first two month period, circuit change intervals in the Group I ventilators were extended from a three time per week (MWF) schedule to a once per week schedule. During that period, Group II ventilators had circuit change interval of three times per week, (MWF). During the second two month period, Group II ventilators had circuit change intervals extended to every seven days while Group I reverted back to the three times per week schedule. During the third two-month period, the circuit change interval schedule of the first two-month period was repeated. Epidemiology and Infection Control staff collected data on VAP rates in compliance with National Nosocomial Infection Surveillance (NNIS) criteria. One way analysis of variance (ANOVA) was performed for statistical analysis.

Results:

Circuit Change Interval
3 times per week once per week
Total Ventilator Days 2279 2338
Total VAP 54 50
Mean VAP Rate 25.42 22.3 p=0.64

Conclusion: There was no significant difference in VAP rates with circuit change intervals extended to seven days versus a three times per week schedule. Work on further extending the circuit change interval may be indicated.

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