Profile of patients in private home care who developed ventilator-associated pneumonia.
Fabiana Schimidt Cezar, Fabiana Camolesi Jacober, Heloísa Amaral Gaspar Gonçalves and 2 others
PMID 39082534WHAT IT FOUND
For every 1,000 days on ventilators, home care had 1.7 ventilator-associated pneumonia cases in adults and 2.2 in children, lower than Brazilian ICU rates.
Key findings
01101 episodes of ventilator-associated pneumonia occurred in 73 patients between July 2021 and June 2022.
02Among patients with ventilator-associated pneumonia, 65.8% were male and 53.4% were adults; central nervous system disorders were the most common diagnosis (57.5%).
03Most episodes were treated at home; 20 patients (19.8%) were treated in hospital, and one death (1%) occurred in the home setting.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective observational study using electronic health records, so it cannot show that home care prevented ventilator-associated pneumonia. The data came from a private home care company, and the authors say they may not reflect patient conditions in other regions or different home care contexts. The authors note that the small sample size of patients with ventilator-associated pneumonia may limit the statistical power for comparisons. Only patients on continuous home mechanical ventilation were included, and patients with COVID-19 were excluded. VAP diagnosis used institutional criteria based on APIC, CDC, and ANVISA, which may not be identical to other settings.
Declared interests
The supplied metadata lists non-U.S. government research support; the article text does not name a specific funder or author conflict declaration.
The easy way to misread this
Do not read the lower home ventilator-associated pneumonia rates as proof that home care prevents pneumonia. This was a retrospective observational study using electronic health records and comparing the home rates with national ICU data, and the authors state that the small sample size limits statistical power.