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dc.creatorÁlvarez-Lerma, F. (Francisco)-
dc.creatorMartínez, M. (Mercedes)-
dc.creatorSánchez-García, M. (Miguel)-
dc.creatorMartinez-Alonso, M. (Montserrat)-
dc.creatorÁlvarez-Rodríguez, J. (Joaquín)-
dc.creatorLorente, L. (Leonardo)-
dc.creatorArias-Rivera, S. (Susana)-
dc.creatorGarcía, R. (Rosa)-
dc.creatorGordo, F. (Federico)-
dc.creatorAñón, J.M. (José M.)-
dc.creatorJam-Gatell, R. (Rosa)-
dc.creatorVazquez-Calatayud, M. (Mónica)-
dc.creatorAgra, Y. (Yolanda)-
dc.identifier.citationÁlvarez-Lerma, F. (Francisco); Palomar-Martínez, M. (Mercedes); Sánchez-García, M. (Miguel); et al. "Prevention of ventilator-associated pneumonia: the multimodal approach of the spanish ICU pneumonia zero program.". Critical care medicine. 46 (2), 2018, 181 - 188es_ES
dc.description.abstractObjectives: The “Pneumonia Zero” project is a nationwide multimodal intervention based on the simultaneous implementation of a comprehensive evidence-based bundle measures to prevent ventilator-associated pneumonia in critically ill patients admitted to the ICU. Design: Prospective, interventional, and multicenter study. Setting: A total of 181 ICUs throughout Spain. Patients: All patients admitted for more than 24 hours to the participating ICUs between April 1, 2011, and December 31, 2012. Intervention: Ten ventilator-associated pneumonia prevention measures were implemented (seven were mandatory and three highly recommended). The database of the National ICU-Acquired Infections Surveillance Study (Estudio Nacional de Vigilancia de Infecciones Nosocomiales [ENVIN]) was used for data collection. Ventilator-associated pneumonia rate was expressed as incidence density per 1,000 ventilator days. Ventilator-associated pneumonia rates from the incorporation of the ICUs to the project, every 3 months, were compared with data of the ENVIN registry (April–June 2010) as the baseline period. Ventilator-associated pneumonia rates were adjusted by characteristics of the hospital, including size, type (public or private), and teaching (postgraduate) or university-affiliated (undergraduate) status. Measurements and Main Results: The 181 participating ICUs accounted for 75% of all ICUs in Spain. In a total of 171,237 ICU admissions, an artificial airway was present on 505,802 days (50.0% of days of stay in the ICU). A total of 3,474 ventilator-associated pneumonia episodes were diagnosed in 3,186 patients. The adjusted ventilator-associated pneumonia incidence density rate decreased from 9.83 (95% CI, 8.42–11.48) per 1,000 ventilator days in the baseline period to 4.34 (95% CI, 3.22–5.84) after 19–21 months of participation. Conclusions: Implementation of the bundle measures included in the “Pneumonia Zero” project resulted in a significant reduction of more than 50% of the incidence of ventilator-associated pneumonia in Spanish ICUs. This reduction was sustained 21 months after implementation.es_ES
dc.description.sponsorshipDr. Alvarez-Lerma’s institution received funding from the Spanish Ministry of Health, Social Policy, and Equality through a contract (Number 2012/07/ CM016) to Spanish Society of Intensive and Critical Care Medicine and Coroanry Units (SEMICYUC). Dr. Sánchez-García received funding for speaker fees from Pfizer, Merck, Sharp & Dohme, Astra-Zeneca, Orion, and Cepheid; for consulting fees from Bayer, GlaxoSmithKline, Pfizer, and Masimo; and for research grants from the European Union, 7th Framework Programme IMI, H2020. Dr. Vázquez-Calatayud disclosed that the study was supported by the Spanish Ministry of Health, Social Policy and Equality through a minor (Number 2012/07/CMO16) and scientific advised by the SEMICYUC and Sociedad Española de Enfermería Intensiva y Unidades Coronariases_ES
dc.publisherLippincott, Williams & Wilkinses_ES
dc.subjectGuideline adherencees_ES
dc.subjectIntensive care unitses_ES
dc.subjectPrevention & controles_ES
dc.subjectVentilator-associated pneumoniaes_ES
dc.titlePrevention of ventilator-associated pneumonia: the multimodal approach of the spanish ICU pneumonia zero program.es_ES
dc.description.noteThis is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.es_ES
dadun.citation.publicationNameCritical care medicinees_ES

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