ABSTRACT 659

Abstract

Background and aims: Ventilator associated pneumonia (VAP) is a serious hospital acquired infection that prolongs intensive care unit (ICU) stay and increases mortality in adults. VAP is common affecting upto 50% of adult ventilated patients but the lack of unified paediatric definition of VAP, it is difficult to estimate its impact in paediatric practice. Aims: Our study aims to define a clinically useful definition of VAP using information from the existing literature; then employ this definition to a cohort of paediatric intensive care patients to determine the incidence of paediatric VAP and its relationship to outcome. Methods: A clinically useful definition of paediatric VAP was defined using a literature search of the existing definitions of VAP in both adults and children. Then through a retrospective case note review and applying this pre-defined definition, the incidence of paediatric VAP in a single PICU within Scotland was determined. IRB waived the need for informed consent. Results: 51 of the 202 ventilated paediatric patients (April 2012 - March 2013) had VAP giving a rate of 25.2%. VAP was associated with a significantly longer duration of ventilation (p < 0.01), a delayed PICU discharge (p < 0.01), but no impact on mortality (p = NS). Our clinical definition had a sensitivity and specificity of 78.4% and 100% respectively for diagnosing VAP. Conclusions: VAP affects 25.2% of ventilated paediatric patients and delays PICU discharge. Further investigations into the prevention of this common hospital acquired infection are warranted.