PMID- 10416907
OWN - NLM
STAT- MEDLINE
DCOM- 19990914
LR  - 20220201
IS  - 0342-4642 (Print)
IS  - 0342-4642 (Linking)
VI  - 25
IP  - 6
DP  - 1999 Jun
TI  - Does noninvasive ventilation reduce the ICU nosocomial infection risk? A 
      prospective clinical survey.
PG  - 567-73
AB  - OBJECTIVE: To observe the nosocomial infection (NI) distribution in ventilated 
      patients of a single intensive care unit (ICU) according to the kind of control 
      of the upper airways: noninvasive positive pressure ventilation (NPPV) versus 
      endotracheal intubation (ETI). SETTING: ICU of a general hospital. DESIGN: 
      Prospective clinical and epidemiologic survey. PATIENTS: In the period December 
      1994-March 1997, 761 patients were included who needed mechanical ventilation for 
      more than 48 h: 129 were ventilated by NPPV (NPPV group), 607 were intubated (ETI 
      group) and 25 required intubation after a period of NPPV (NPPV-ETI group). 
      MEASUREMENTS AND RESULTS: The data used were prospectively collected according to 
      the NI epidemiologic surveillance protocol of "C. CLIN Sud Est, Rea Sud Est", 
      France. NI included a ventilator-associated pneumonia (VAP), catheter-related 
      infection, urinary tract infection and bacteremia. Occurrence of NI was estimated 
      by the density of incidence. Covariate-adjusted NI and VAP risk factors were 
      assessed by the Cox model. The incidence density of total NI was lower for NPPV 
      than for ETI (14.2 versus 30.3 per 1000 patient-days, p < 0.01). The Cox model 
      showed that the use of noninvasive ventilation, adjusted to the severity of 
      illness (SAPS II), reduced not only the VAP risk (hazard ratio (HR) = 4.07) but 
      also the NI risk (HR = 1.95). CONCLUSION: The use of NPPV reduces the risk of VAP 
      and NI, compared to ETI, irrespective of the severity of the patient's illness.
FAU - Nourdine, K
AU  - Nourdine K
AD  - Service de Reanimation, Centre Hospitalier de Roanne, France.
FAU - Combes, P
AU  - Combes P
FAU - Carton, M J
AU  - Carton MJ
FAU - Beuret, P
AU  - Beuret P
FAU - Cannamela, A
AU  - Cannamela A
FAU - Ducreux, J C
AU  - Ducreux JC
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Intensive Care Med
JT  - Intensive care medicine
JID - 7704851
SB  - IM
CIN - Intensive Care Med. 1999 Jun;25(6):553-5. PMID: 10416905
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Analysis of Variance
MH  - Critical Care
MH  - Cross Infection/epidemiology/etiology/*prevention & control
MH  - Data Interpretation, Statistical
MH  - Female
MH  - France/epidemiology
MH  - Humans
MH  - Incidence
MH  - *Intensive Care Units
MH  - Intermittent Positive-Pressure Ventilation/*adverse effects
MH  - Intubation, Intratracheal/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Pneumonia/epidemiology/etiology/prevention & control
MH  - Prohibitins
MH  - Prospective Studies
MH  - Risk Factors
EDAT- 1999/07/23 00:00
MHDA- 1999/07/23 00:01
CRDT- 1999/07/23 00:00
PHST- 1999/07/23 00:00 [pubmed]
PHST- 1999/07/23 00:01 [medline]
PHST- 1999/07/23 00:00 [entrez]
AID - 10.1007/s001340050904 [doi]
PST - ppublish
SO  - Intensive Care Med. 1999 Jun;25(6):567-73. doi: 10.1007/s001340050904.