A new report out of the University of Connecticut is raising concern about hospital-acquired infections from respirators.
The paper looked at VAP or ventilator-associated pneumonia. That's an infection acquired in a hospital after a patient is put on a respirator, which can increase the length of stay, costs, and mortality.
Some federal data from the Centers for Disease Control and Prevention suggests VAP infection rates are declining, but Mark Metersky, a doctor at UConn and lead author of the study, said they are not.
"What our study shows, that is challenging some of the conventional wisdom, is the rates have not gone down," Metersky said. "About one in 10 patients who was on a ventilator in an acute-care hospital for more than 48 hours will develop that complication. And that rate looks like it's been fairly stable for at least 10 years."
In his study, Metersky looked at data from the Medicare Patient Safety Monitoring System, focusing specifically on groups of VAP-diagnosed patients, 65 years and older, with certain pre-existing conditions from hundreds of different hospitals.
"This is fairly representative of the types of patients who are ending up in ICUs," Metersky said.
VAP infections in already-sick patients can be hard to diagnose -- and Metersky said infection rates sent to the CDC by hospitals, not individual doctors, can be subject to varied reporting standards or possible bias.
"Because you want to do well, you want to show that your rates are down. You're in a hospital that's probably trying to do things to prevent this, and you want to believe that it's working," Metersky said.
Charles Dela Cruz, director of the Center of Pulmonary Infection Research and Treatment at the Yale School of Medicine, who wasn't involved with the paper, said the study shows hospitals and ICUs need to do better.
"We should not be confident that ventilator-associated pneumonia has been solved," Dela Cruz said. "Because the notion that there's a decline in ventilator-associated pneumonia, I feel that there's been less of an attention to it.
Both doctors say they hope the paper raises awareness that more research is needed to understand how VAP infections are acquired and how they can be prevented.
Metersky's work appears in the Journal of the American Medical Association.
