ArticleCritical care medicine2018
Prevention of Ventilator-Associated Pneumonia: The Multimodal Approach of the Spanish ICU "Pneumonia Zero" Program.
Article in Critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06113939 (Prevention of Infection of the Respiratory Tract by Applying Methods That Are Non-Invasive for Extraction of Secretions. An Open Label, Randomized, Assessor-blinded Trial.), which is not on this map. Cited by 57 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prevention of Infection of the Respiratory Tract by Applying Methods That Are Non-Invasive for Extraction of Secretions. An Open Label, Randomized, Assessor-blinded Trial.
Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Subglottic secretion drainage for preventing ventilator-associated pneumonia: an overview of systematic reviews and an updated meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2020Pooled it
- Comparison of Mechanical Insufflation-Exsufflation and Hypertonic Saline and Hyaluronic Acid With Conventional Open Catheter Suctioning in Intubated Patients.Respiratory care · 2024Trial
- The effect of an infection control guideline on the incidence of ventilator-associated pneumonia in patients admitted to the intensive care units.BMC infectious diseases · 2023Trial
- Prevention of Ventilator-Associated Pneumonia in Intensive Care Units: The Effect of Scenario-Based Simulation on Nursing Students' Skill Development Process.Nursing in critical care · 2026Article
- Are arms-based methods required to test the stable unit treatment value assumption (SUTVA) among Cochrane reviews of contagious infection prevention interventions?Global epidemiology · 2026Article
- Arms-Based Meta-Analysis of Microbiological Endpoints of 88 VAP Prevention Studies Using Antimicrobial Versus Non-Antimicrobial Strategies-Towards 'VAP-Zero'?Antibiotics (Basel, Switzerland) · 2026Article
- Protocolized antimicrobial stewardship following filmarray pneumonia plus panel testing in mechanically ventilated patients with severe lower respiratory tract infection.Scientific reports · 2026Article
- Systematic reviews and the Journal of Antimicrobial Chemotherapy; past, present and future. A systematic reappraisal.The Journal of antimicrobial chemotherapy · 2025Article
- Testing the Stable Unit Treatment Variance Assumption (SUTVA) Within Cochrane Reviews of Antimicrobial-Based Pneumonia Prevention Interventions Among Mechanically Ventilated Patients Using Caterpillar Plots.Journal of clinical medicine · 2025Article
- Estimating the herd effects of antimicrobial prevention interventions on ventilator-associated pneumonia within ICU populations: a cluster randomized trial emulation using data from Cochrane reviews.The Journal of antimicrobial chemotherapy · 2025Article
- Vascular catheter-related infections: an endemic disease in healthcare institutions. An opinion paper of the Spanish Society of Cardiovascular Infections (SEICAV).Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Review
- Visualizing and diagnosing spillover within randomized concurrent controlled trials through the application of diagnostic test assessment methods.BMC medical research methodology · 2024Article
- Specialized nursing intervention on critically ill patient in the prevention of intubation-associated pneumonia: an integrative literature review.Acute and critical care · 2024Article
- The Relationship between Selective Digestive Decontamination and Nosocomial Infections in Patients Receiving Continuous Renal Replacement Therapy in ICUs: A Multicenter Study.Journal of clinical medicine · 2024Article
- Pneumonia Characteristics in an Intensive Care Unit Setting during and after the COVID-19 Pandemic-A Single-Center Prospective Study.Journal of clinical medicine · 2024Article
- Prevention of ventilator-associated pneumonia through care bundles: A systematic review and meta-analysis.Journal of intensive medicine · 2023Article
- Ten Issues to Update in Nosocomial or Hospital-Acquired Pneumonia: An Expert Review.Journal of clinical medicine · 2023Review
- Clinical, Microbiological and Treatment Characteristics of Severe Postoperative Respiratory Infections: An Observational Cohort Study.Journal of personalized medicine · 2023Article
- Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia.Biomedicines · 2023Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe "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.
designProspective, interventional, and multicenter study.
settingA 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.
interventionTen 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
resultsThe 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.
conclusionsImplementation 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.
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