Ventilator-associated events: From surveillance to optimizing management  

作　　者：Sergio Ramirez-Estrada Yolanda Peña-Lopez Tarsila Vieceli Jordi Rello 

机构地区：[1]Intensive Care Department,Hospital Sanitas CIMA,Barcelona 08034,Spain [2]Paediatric Critical Care Department,Hospital Universitari Vall d’Hebron,Barcelona 08035,Spain [3]Clinical Research/Epidemiology in Pneumonia and Sepsis(CRIPS),Vall d’Hebron Research Institute,Barcelona 08035,Spain [4]Infectious Diseases Department,Hospital de Clínicas de Porto Alegre,Porto Alegre RS 90035-007,Brazil [5]Universitat Internacional de Catalunya,Barcelona 08195,Spain

出　　处：《Journal of Intensive Medicine》2023年第3期204-211,共8页重症医学（英文）

摘　　要：Mechanical ventilation(MV)is a life-support therapy that may predispose to morbid and lethal complications,with ventilator-associated pneumonia(VAP)being the most prevalent.In 2013,the Center for Disease Control(CDC)defined criteria for ventilator-associated events(VAE).Ten years later,a growing number of studies assessing or validating its clinical applicability and the potential benefits of its inclusion have been published.Surveillance with VAE criteria is retrospective and the focus is often on a subset of patients with higher thanlower severity.To date,it is estimated that around 30%of ventilated patients in the intensive care unit(ICU)develop VAE.While surveillance enhances the detection of infectious and non-infectious MV-related complicationsthat are severe enough to impact the patient’s outcomes,there are still many gaps in its classification and management.In this review,we provide an update by discussing VAE etiologies,epidemiology,and classification.Preventive strategies on optimizing ventilation,sedative and neuromuscular blockade therapy,and restrictivefluid management are warranted.An ideal VAE bundle is likely to minimize the period of intubation.We believethat it is time to progress from just surveillance to clinical care.Therefore,with this review,we have aimed toprovide a roadmap for future research on the subject.

关 键 词：Intensive care Mechanical ventilation Infection control Ventilator-associated pneumonia 

分 类 号：R56[医药卫生—呼吸系统]