The following is a summary of “Assessing the impact of a multidimensional approach and an 8-component bundle in reducing incidences of ventilator-associated pneumonia across 35 countries in Latin America, Asia, the Middle East, and Eastern Europe,” published in the April 2024 issue of Critical Care by Rosenthal et al.

Researchers conducted a retrospective study investigating the association between physiotherapy and ventilator-associated pneumonia (VAP) rates in the ICU.

They deployed a multidimensional approach and an 8-component bundle in 374 ICUs spanning 35 low and middle-income countries (LMICs) in Latin America, Asia, Eastern Europe, and the Middle East. The intervention aimed to diminish VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was gauged at baseline and throughout the intervention at various time intervals: the 2nd month, 3rd month, 4–15 months, 16–27 months, and 28–39 months.

The results showed 174,987 patients, over 1,201,592 patient days, utilized 463,592 MV-days. VAP rates per 1000 MV-days declined from 28.46 at baseline to 17.58 in the 2nd month (RR = 0.61; 95% CI = 0.58–0.65; P<0.001); 13.97 in the 3rd month (RR = 0.49; 95% CI = 0.46–0.52; P<0.001); 14.44 in the 4–15 month (RR = 0.51; 95% CI = 0.48–0.53; P<0.001); 11.40 in the 16–27 month (RR = 0.41; 95% CI = 0.38–0.42; P<0.001), and to 9.68 in the 28–39 month (RR = 0.34; 95% CI = 0.32–0.36; P<0.001). The multilevel Poisson regression model demonstrated a continual significant decline in incidence rate ratios, reaching 0.39 (P<0.0001) during the 28th to 39th months post-intervention implementation.

Investigators concluded a sustained 66% reduction in VAP rates, persisting throughout the 39-month study period.

Source: sciencedirect.com/science/article/abs/pii/S0883944123002496