LETTER
Ventilator Circuit Changes
Lenore E. Asbel, MD, and
Caroline C. Johnson, MD
15 May 1996 | Volume 124 Issue 10 | Page 929
TO THE EDITOR:
In their recent article, Kollef and associates [1] studied whether routinely changing ventilator circuitry affected the incidence of nosocomial pneumonia. We were surprised to see that the results were not expressed as rates of infected patients per 1000 ventilator-days, as recommended by the Hospital Infection Control Practices Advisory Committee and the Centers for Disease Control and Prevention's National Center for Infectious Diseases for surveillance of nosocomial pneumonias [2]. The authors report the average duration of mechanical ventilation but not actual rates of infection. Thus, their results cannot be easily compared with those of other studies or with hospital surveillance data [3]. As has been previously stated, "meaningful comparisons [in hospital epidemiology] can be made only if uniform definitions of rates are adopted" [4].
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Author and Article Information
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Medical College of Pennsylvania; Philadelphia, PA 19129
1. Kollef MH, Shapiro SD, Fraser VJ, Silver D, Murphy DM, Trovillion E, et al. Mechanical ventilation with or without 7-day circuit changes. A randomized controlled trial. Ann Intern Med. 1995; 123:168-74.
2. Draft guideline for prevention of nosocomial pneumonia: notice of comment period. Centers for Disease Control and Prevention. Federal Register. 1994; 59:4980-5022.
3. Hess D, Burns E, Romagnoli D, Kachmarek RM. Weekly ventilator circuit changes, a strategy to reduce cost without affecting pneumonia rates. Anesthesiology. 1995; 82:903-11.
4. Freeman J, McGowan JE. Methodologic issues in hospital epidemiology. I. Rates, case-finding and interpretation. Rev Infect Dis. 1981; 3:658-67.
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