Application of Ventilator-Associated Events (VAE) in Ventilator-Associated Pneumonia (VAP) Notified in Brazil

NCT ID: NCT05589727

Last Updated: 2024-11-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

987 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-10-21

Study Completion Date

2024-01-21

Brief Summary

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Multicentric observational prospective cohort study in 12 (twelve) hospitals representing all Brazilian regions.

The main objective of this project is to evaluate the incidence of Ventilator-Associated Pneumonia (VAP) when using the current ANVISA criteria for VAP versus VAE criteria defined by the National Healthcare Safety Network (NHSN). The diagnostic accuracy of the two criteria for identifying VAP will also be compared, characterizing other events associated with mechanical ventilation that are not VAP, when applicable.

The study also aims to adjudicate ventilator-associated pneumonias reported to ANVISA using current epidemiological diagnostic criteria.

Detailed Description

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The study will be carried out in about 12 centers, comprising the five Brazilian regions. It will be conducted from 2022 to 2024. Data collection will be performed at each center during six months.

Trained health professionals from Infections Control Committees of each participating center will collect data.

Mechanical ventilation data will be entered daily in the database system from the moment the patient is submitted to mechanical ventilation until the first day after the end of mechanical ventilation.

VAPs notified to ANVISA, according to its own criteria, will be reported monthly in the database system for adjudication.

The VAE definition will be performed automatically in the database system by mans of a specific algorithm. The diagnosis established by the system will be manually validated by a nurse with experience in healthcare-associated infection (HAI) surveillance. Agreement variables (Kappa) between the two criteria will be analyzed.

The adjudication will be carried out by two independent professionals (doctor and nurse) with experience in HAIs surveillance. In case of disagreement, there will be an evaluation by a third adjudicator.

The complete project was submitted to the local Institutional Review Board (IRB)/National Research Ethics Commission (CONEP) system and has ethical approval (CAAE: 52354721.0.1001.0070).

Conditions

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Ventilator-Associated Pneumonia Healthcare-Associated Pneumonia Healthcare Associated Infection

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients with VAP - ANVISA criteria

Patients notified with Ventilator-Associated Pneumonia (VAP) when using the current ANVISA criteria.

No interventions assigned to this group

Patients with VAP - NHSN criteria

Patients notified with Ventilator-Associated Pneumonia (VAP) when using the Ventilator-Associated Events (VAE) criteria defined by the NHSN.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patients aged 18 years or older
* Pacients hospitalized in intensive care units (ICUs) using mechanical ventilation

Exclusion Criteria

* Patients withdrawn from mechanical ventilation (MV) on the first day (D1) or second day (D2), with D1 being the day of initiation of MV;
* Patients with hospital discharge (discharge, death or transfer) on D1 or D2 of mechanical ventilation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Health, Brazil

OTHER_GOV

Sponsor Role collaborator

Giovanna Marssola Nascimento

OTHER

Sponsor Role lead

Responsible Party

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Giovanna Marssola Nascimento

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Giovanna M Nascimento, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital Alemão Oswaldo Cruz

Locations

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Hospital São Vicente de Paula

Barbalha, Ceará, Brazil

Site Status

Hospital OTOclínica

Fortaleza, Ceará, Brazil

Site Status

Hospital Universitário de Brasília

Brasília, Federal District, Brazil

Site Status

Hospital Geral de Goiânia Alberto Rassi

Goiânia, Goiás, Brazil

Site Status

Hospital Presidente Vargas

São Luís, Maranhão, Brazil

Site Status

Hospital Municipal de Maringá

Maringá, Paraná, Brazil

Site Status

Hospital Jean Bittar

Belém, Pará, Brazil

Site Status

Hospital do Tricentenário

Olinda, Pernambuco, Brazil

Site Status

Instituto Estadual do Cérebro Paulo Niemeyer

Rio de Janeiro, Rio de Janeiro, Brazil

Site Status

Hospital Geral de Caxias do Sul

Caxias do Sul, Rio Do Grande Do Sul, Brazil

Site Status

Hospital Ernesto Dornelles

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

A. C. Camargo Cancer Center

São Paulo, São Paulo, Brazil

Site Status

Countries

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Brazil

References

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Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008 Jun;36(5):309-32. doi: 10.1016/j.ajic.2008.03.002. No abstract available.

Reference Type BACKGROUND
PMID: 18538699 (View on PubMed)

Klompas M. Ventilator-Associated Events: What They Are and What They Are Not. Respir Care. 2019 Aug;64(8):953-961. doi: 10.4187/respcare.07059.

Reference Type BACKGROUND
PMID: 31346070 (View on PubMed)

Klompas M. The paradox of ventilator-associated pneumonia prevention measures. Crit Care. 2009;13(5):315. doi: 10.1186/cc8036. Epub 2009 Oct 15.

Reference Type BACKGROUND
PMID: 19849825 (View on PubMed)

Fan Y, Gao F, Wu Y, Zhang J, Zhu M, Xiong L. Does ventilator-associated event surveillance detect ventilator-associated pneumonia in intensive care units? A systematic review and meta-analysis. Crit Care. 2016 Oct 24;20(1):338. doi: 10.1186/s13054-016-1506-z.

Reference Type BACKGROUND
PMID: 27772529 (View on PubMed)

Raoof S, Baumann MH; Critical Care Societies Collaborative, consisting of the leadership of the American Association of Critical-Care Nurses, the American College of Chest Physicians, the American Thoracic Society, and the Society of Critical Care Medicine. Ventilator-associated events: the new definition. Am J Crit Care. 2014 Jan;23(1):7-9. doi: 10.4037/ajcc2014469. No abstract available.

Reference Type BACKGROUND
PMID: 24382609 (View on PubMed)

Stevens JP, Silva G, Gillis J, Novack V, Talmor D, Klompas M, Howell MD. Automated surveillance for ventilator-associated events. Chest. 2014 Dec;146(6):1612-1618. doi: 10.1378/chest.13-2255.

Reference Type BACKGROUND
PMID: 25451350 (View on PubMed)

Hebert C, Flaherty J, Smyer J, Ding J, Mangino JE. Development and validation of an automated ventilator-associated event electronic surveillance system: A report of a successful implementation. Am J Infect Control. 2018 Mar;46(3):316-321. doi: 10.1016/j.ajic.2017.09.006. Epub 2017 Nov 10.

Reference Type BACKGROUND
PMID: 29132696 (View on PubMed)

Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005 Mar;85(3):257-68.

Reference Type BACKGROUND
PMID: 15733050 (View on PubMed)

Donner A, Eliasziw M. A goodness-of-fit approach to inference procedures for the kappa statistic: confidence interval construction, significance-testing and sample size estimation. Stat Med. 1992 Aug;11(11):1511-9. doi: 10.1002/sim.4780111109.

Reference Type BACKGROUND
PMID: 1410963 (View on PubMed)

Nascimento GM, Rodrigues DLG, Piastrelli FT, Cheno MY, Braz KCC, Alves LBO, Tomazini BM, Veiga VC, Arns B, Besen BAMP, Junior APN, Avezum A, da Silva RKL, de Azevedo CMPES, Silva MLSO, Kist GR, Salgado FB, de Moura MTF, Boschi E, Kurtz PMP, Miraglia ERVDS, de Lima TA, Pereira RR, Arraes JA, Alves de Oliveira Junior H. Ventilator-associated events criteria in the assessment of Ventilator-Associated Pneumonia (IMPACTO MR-PAV): A prospective cohort. Braz J Infect Dis. 2025 Jul-Aug;29(4):104543. doi: 10.1016/j.bjid.2025.104543. Epub 2025 May 22.

Reference Type DERIVED
PMID: 40409133 (View on PubMed)

Nascimento GM, Gomes Rodrigues DL, Mangas Catarino DG, Piastrelli FT, Cheno MY, Braz KCC, Oliveira Alves LB, Avezum A, Veiga VC, Zavascki AP, Tomazini B, Besen B, Pereira AJ, Marques de Pinho APN, De Oliveira Junior HA. Application of ventilator-associated events (VAE) in ventilator-associated pneumonia (VAP) notified in Brazil (IMPACTO MR-PAV): a protocol for a cohort study. BMJ Open. 2023 Dec 9;13(12):e076047. doi: 10.1136/bmjopen-2023-076047.

Reference Type DERIVED
PMID: 38070904 (View on PubMed)

Other Identifiers

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IMPACTO MR-PAV

Identifier Type: -

Identifier Source: org_study_id

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