TABLE 3.
Ventilator-Associated Condition and Infection-Related Ventilator-Associated Complication Bivariate Risk Factor Analysis
| Variable | VAC Cases | Controls | OR (95% CI) | p | Infection-Related Ventilator-Associated Complication Cases | Controls | OR (95% CI) | p |
|---|---|---|---|---|---|---|---|---|
| Classic ventilator bundle components: mean % adherence over 3 d prior to VAC (SD) | ||||||||
| Head of bed elevation | 77 (28) | 74 (32) | 1.01 (1.00–1.02) | NS | 73 (34) | 75 (35) | 1.00 (0.98–1.01) | NS |
| Oral care with chlorhexidine | 77 (26) | 82 (30) | 1.01 (1.00–1.02) | NS | 75 (29) | 75 (33) | 1.00 (0.98–1.02) | NS |
| Deep venous thrombosis prophylaxis | 80 (27) | 74 (31) | 1.01 (1.00–1.02) | NS | 77 (32) | 77 (32) | 1.00 (0.98–1.02) | NS |
| Stress ulcer prophylaxis | 85 (24) | 79 (28) | 1.01 (1.00–1.02) | 0.08 | 83 (28) | 80 (29) | 1.01 (0.98–1.02) | NS |
| Sedative interruption | 47 (38) | 45 (35) | 1.00 (0.99–1.01) | NS | 44 (39) | 49 (37) | 1.00 (0.98–1.01) | NS |
| Spontaneous breathing trial | 22 (31) | 21 (30) | 1.00 (0.99–1.01) | NS | 21 (30) | 22 (31) | 1.00 (0.98–1.02) | NS |
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| Nutrition over 3 d prior to VAC (%) | ||||||||
| Nothing by mouth 100% of the time | 36 (33) | 36 (33) | 1.00 (0.49–2.06) | NS | 10 (26) | 11 (29) | 0.86 (0.28–2.58) | NS |
| Tube feeding—any exposure | 59 (54) | 68 (62) | 0.64 (0.34–1.19) | NS | 26 (68) | 26 (68) | 1.00 (0.34–2.92) | NS |
| Parenteral nutrition—any exposure | 15 (14) | 11 (10) | 1.50 (0.62–3.83) | NS | 2 (5.3) | 3 (7.9) | 0.67 (0.09–4.02) | NS |
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| Blood products: mean (units over 3 d prior to VAC) (SD) | ||||||||
| RBC | 0.63 (1.3) | 0.56 (1.6) | 1.04 (0.85–1.30) | NS | 0.7 (1.5) | 0.7 (2.3) | 1.01 (0.75–1.36) | NS |
| Fresh-frozen plasma | 0.44 (1.3) | 0.40 (1.4) | 1.03 (0.81–1.31) | NS | 0.5 (1.3) | 0.7 (2.1) | 0.92 (0.61–1.28) | NS |
| Platelets | 0.13 (0.4) | 0.15 (0.6) | 0.92 (0.50–1.64) | NS | 0.1 (0.3) | 0.3 (1.0) | 0.70 (0.20–1.47) | NS |
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| Sedative and paralytic medications: mean total dose over 7 d prior to VAC (SD) | ||||||||
| Total sedatives (propofol + benzodiazepines), mg midazolam equivalents/kg | 4.7 (5.5) | 5.9 (6.7) | 0.96 (0.91–1.01) | 0.10 | 6.1 (6.8) | 7.0 (7.4) | 0.98 (0.91–1.05) | NS |
| Total benzodiazepine, mg midazolam equivalents/kg | 1.0 (1.2) | 1.0 (1.5) | 1.00 (0.85–1.18) | NS | 0.9 (1.1) | 0.9 (1.2) | 1.01 (0.67–1.53) | NS |
| Propofol, mg midazolam equivalents/kg | 3.7 (5.2) | 4. (6.6) | 0.96 (0.91–1.01) | NS | 5.2 (6.8) | 6.1 (7.5) | 0.98 (0.91–1.05) | NS |
| Total opioid, 100 μg fentanyl equivalents/kg | 0.66 (0.95) | 0.62 (0.89) | 1.06 (0.77–1.50) | NS | 0.67 (0.64) | 0.49 (0.54) | 2.64 (0.90–9.6) | 0.08 |
| Dexmedetomidine, mg/kg | 0.3 (1.5) | 0.7 (4.6) | 0.95 (0.82–1.04) | NS | 0.1 (1.3) | 1.2 (7.1) | 0.95 (0.68–1.05) | NS |
| Cisatracurium, mg/kg | 0.3 (1.3) | 0.4 (1.4) | 0.98 (0.80–1.19) | NS | 0.6 (1.9) | 0.5 (1.9) | 1.02 (0.79–1.35) | NS |
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| Any cisatracurium within the 7 d prior to VAC (%) | 13 (12) | 11 (10) | 1.20 (0.52–2.84) | NS | 8 (21) | 4 (11) | 2.33 (0.65–10.83) | NS |
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| Richmond Agitation Sedation Scale: 7-day mean prior to VAC (SD) | –2.8 (1.4) | –2.6 (1.7) | 0.85 (0.64–1.08) | NS | –3.1 (1.2) | –2.9 (1.3) | 0.75 (0.44–1.19) | NS |
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| Fluid balance: 3-day mean/d prior to VAC (SD) | ||||||||
| Ins, L | 4.9 (3.7) | 3.8 (2.6) | 1.20 (1.05–1.41) | 0.003 | 4.7 (3.8) | 4.3 (3.1) | 1.07 (0.90–1.31) | NS |
| Outs, L | 2.5 (2.1) | 2.5 (1.4) | 1.01 (0.85–1.21) | NS | 2.4 (1.5) | 2.8 (1.5) | 0.66 (0.36–1.07) | 0.10 |
| Net balance, L | 2.4 (3.4) | 1.5 (2.3) | 1.20 (1.06–1.40) | 0.004 | 2.4 (3.8) | 1.6 (2.5) | 1.13 (0.95–1.43) | NS |
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| Fluid balance: 7-day mean/d prior to VAC (SD) | ||||||||
| Ins, L | 4.8 (3.5) | 3.8 (2.5) | 1.19 (1.05–1.38) | 0.004 | 4.7 (3.8) | 4.1 (3.0) | 1.08 (0.92–1.31) | NS |
| Outs, L | 2.4 (1.6) | 2.3 (1.3) | 1.07 (0.87–1.34) | NS | 2.4 (1.4) | 2.6 (14) | 0.79 (0.46–1.25) | NS |
| Net balance, L | 2.4 (3.3) | 1.6 (2.1) | 1.16 (1.03–1.35) | 0.015 | 2.3 (3.7) | 1.6 (2.3) | 1.10 (0.93–1.36) | NS |
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| Ventilator settings: 7-day mean prior to VAC onset (SD) | ||||||||
| Minimum tidal volume, mL/kg | 5.3 (1.6) | 5.1 (1.4) | 1.12 (0.91–1.39) | NS | 5.5 (1.3) | 5.1 (1.4) | 1.51 (0.95–2.59) | 0.08 |
| Maximum tidal volume, mL/kg | 7.7 (2.4) | 7.6 (2.4) | 1.01 (0.89–1.15) | NS | 8.0 (1.9) | 7.5 (2.3) | 1.14 (0.89–1.48) | NS |
| % of days on mandatory ventilatory modes at minimum TV | 62 (40) | 54 (38) | 1.01 (1.00–1.02) | 0.05 | 61 (37) | 54 (37) | 1.01 (0.99–1.02) | NS |
| % of days on mandatory ventilatory modes at maximum TV | 54 (41) | 42 (37) | 1.01 (1.00–1.02) | 0.007 | 52 (37) | 44 (37) | 1.01 (0.99–1.02) | NS |
| Mandatory ventilatory modes 100% of days at minimum TV (%) | 48 (44) | 35 (32) | 2.00 (1.05–4.02) | 0.04 | 13 (34) | 10 (26) | 1.50 (0.54–4.47) | NS |
| Mandatory ventilatory modes 100% of days at maximum TV (%) | 40 (36) | 21 (19) | 2.73 (1.41–5.69) | 0.003 | 10 (26) | 7 (18) | 1.60 (0.53–5.29) | NS |
VAC = ventilator-associated conditions, OR = odds ratio, NS = not significant, TV = tidal volume.
Boldface text highlights comparisons where the p value for the difference between cases and controls ≤ 0.10.