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March 14, 2026Respiratory Care0 citations

The Impact of VAE Monitoring on the Care of ICU Ventilator-Dependent Patients

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JLJui-Fang LiuHCHwei-Ling Chou

Key Points

  • To investigate the effect of VAE monitoring on the care of mechanically ventilated ICU patients.
  • Retrospective observational study
  • Utilized data from Chang Gung Memorial Hospital database
  • Conducted multicenter VAE surveillance study
  • Included patients aged 18 and older on mechanical ventilation for more than 3 days
  • Excluded patients on ECMO or with short ventilation duration.
  • Study included 308 patients; 161 in VAC group, 147 in without VAC group
  • VAC group had higher COPD (8.7% vs. 2.7%) and collagen disease (3.7% vs. 0.0%)
  • Chronic renal failure was less common in the VAC group (14.3% vs. 33.3%)
  • VAC group had significantly higher APACHE II scores and longer ICU stays
  • Sensitivity to increases in FIO2 >0.20 and PEEP >3 cm H2O in VAC group allows earlier ventilator adjustments.

Abstract

Background: This study aims to investigate whether a real-time monitoring system based on ventilator-associated events (VAE) can improve the quality of care for ICU patients on mechanical ventilation. Furthermore, it seeks to analyze the profile of VAE in ICU mechanically ventilated patients and the impact of VAE monitoring on these patients. Methods: This retrospective observational study utilized data from the Chang Gung Memorial Hospital database to conduct a multicenter VAE surveillance study. The study period was from October 1, 2022, to September 30, 2023, and included patients aged 18 years and older who met the VAE criteria and had been on mechanical ventilation for more than 3 days. Patients younger than 18, those on mechanical ventilation for less than 3 days, and those using extracorporeal life support systems, high-frequency ventilators, or ECMO were excluded. Results: The study included 308 patients (VAC group, n = 161; without VAC group, n = 147). The results showed that the VAC group had a higher prevalence of COPD (8.7% vs. 2.7%, P 0.20, 87.0% had a PEEP increase >3 cm H2O, and only 19.3% had both an FIO2 increase >0.20 and a PEEP increase >3 cm H2O. In contrast, in the without VAC group, 50.3% had IVAV, and 31.1% had VAP. Additionally, the VAC group had significantly higher APACHE II scores, longer antibiotic usage, longer MV duration, and longer ICU stays. Conclusions: The occurrence of VAC in the VAC group under VAE monitoring indicates that patients are more sensitive to increases in FIO2 >0.20 and PEEP >3 cm H2O. This sensitivity allows for earlier adjustment of ventilator parameters, reducing the risk of mechanical ventilation-related complications.

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Cite This Study

Liu et al. (2024) studied this question.

synapsesocial.com/papers/69b4ad7918185d8a39800d80https://doi.org/10.4187/respcare.20244138274
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