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Am J Perinatol 2024; 41(05): 580-585
DOI: 10.1055/a-1739-3678
Original Article

Ventilator-Free Days in Neonatal Ventilator-Associated Pneumonia

Anucha Thatrimontrichai 
1   Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
,
Manapat Phatigomet
1   Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
,
Gunlawadee Maneenil 
1   Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
,
Supaporn Dissaneevate
1   Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
,
Waricha Janjindamai
1   Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
,
Supika Kritsaneepaiboon
2   Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
› Author Affiliations Funding None.
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Abstract

Objective This study aimed to compare the ventilator-free days (VFDs) at day 28 and the short-term outcomes in neonates with and without ventilator-associated pneumonia (VAP and non-VAP groups).

Study Design We performed a cohort study in a Thai neonatal intensive care unit between 2014 and 2020 to identify the VFDs in VAP and non-VAP neonates. Univariate and multivariate analyses were performed.

Results The incidences of VAP rates were 5.76% (67/1,163 neonates) and 10.86 per 1,000 (92/8,469) ventilator days. The medians (interquartile ranges [IQRs]) of gestational age and birth weight in the VAP versus non-VAP groups were 31 (27–35) versus 34 (30–38) weeks, and 1,495 (813–2,593) versus 2,220 (1,405–2,940) g (p < 0.001, both), respectively. The medians (IQRs) of VFDs at 28 days in the VAP and non-VAP groups were 5 (0–16) and 24 (20–26) days (p < 0.001). From the univariate analysis, the lower VFDs, longer ventilator days, and higher rates of moderate-to-severe bronchopulmonary dysplasia (BPD), postnatal steroids for BPD, length of stay, and daily hospital cost in the VAP group were significantly higher than in the non-VAP group. From the multivariate analysis, the VAP group had significantly lower VFDs (regression coefficient = −10.99, standard error = 1.11, p < 0.001) and higher BPD (adjusted risk ratio = 18.70; 95% confidence interval = 9.17–39.5, p < 0.001) than the non-VAP group.

Conclusion Neonatal VAP lead to lower VFDs and a higher frequency of BPD. A multimodal strategy with a VAP prevention bundle care should be used in indicated cases to reduce the occurrence of neonatal VAP.

Key Points

  • The VFDs of the neonatal VAP was lower than reported in adult study.

  • There are limited data on VFDs in VAP during the neonatal period.

  • Neonatal VAP reduces VFDs and increases BPD rates compared with non-VAP infants.

Keywords

bronchopulmonary dysplasia - neonatal intensive care unit - newborn - ventilator-associated pneumonia - ventilator-free days

Authors' Contributors

A.T. conceptualized and designed the study, contributed to data acquisition, supervised the data analysis, drafted the initial manuscript, and reviewed and revised the manuscript. M.P., G.M., S.D., W.J., and S.K. contributed to the study conceptualization, data acquisition and analysis and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.




Publication History

Received: 24 October 2021

Accepted: 12 January 2022

Accepted Manuscript online:
13 January 2022

Article published online:
14 February 2022

© 2022. Thieme. All rights reserved.

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