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Vol. 41. Issue 8.
Pages 439-456 (August 2005)
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Vol. 41. Issue 8.
Pages 439-456 (August 2005)
Recommendations of the Latin American Thoracic Society (ALAT)
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Clinical Guidelines for the Treatment of Nosocomial Pneumonia in Latin America: an Interdisciplinary Consensus Document
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C.M. Lunaa,
Corresponding author
cymluna@fmed.uba.ar

Correspondence: Dr. C.M. Luna. Acevedo, 1070. 1828 Banfield. Buenos Aires. Argentina
, A. Monteverdeb, A. Rodríguezc, C. Apezteguiaa,b,c, G. Zaberta,b,c, S. Ilutovichc, G. Mengaa,b, W. Vasend, A.R. Díeza,b,c, J. Merad, for the Argentinian-Latin American Study Group on Nosocomial Pneumonia (GALANN) *
a Asociación Argentina de Medicina Respiratoria, Buenos Aires, Argentina
b Asociación Latinoamericana del Tórax, São Paulo, Brazil
c Sociedad Argentina de Terapia Intensiva, Buenos Aires, Argentina
d Sociedad Argentina de Infectología, Buenos Aires, Argentina
e Sociedad Argentina de Bacteriología Clínica, Buenos Aires, Argentina
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REFERENCES
[1]
F Rodríguez de Castro, J Sole Violan, J Caminero Luna.
Neumonía nosocomial, epidemiología, factores de riesgo y pronóstico.
Arch Bronconeumol, 34 (1998), pp. 25-30
[2]
SH Kirtland, DE Corley, RH Winterbauer, SC Springmeyer, KR Casey, NB Hampson, et al.
The diagnosis of ventilator associated pneumonia. A comparison of histologic, microbiologic and clinical criteria.
Chest, 112 (1997), pp. 445-457
[3]
CH Marquette, MC Copin, F Wallet, R Neviere, F Saulnier, D Mathieu, et al.
Relationship between microbiologic and histologic features in bacterial pneumonia.
Am J Respir Crit Care Med, 154 (1996), pp. 1784-1787
[4]
SK Pingleton, J-Y Fagon, KV Leeper.
Patient selection for clinical investigation of ventilator-associated pneumonia: criteria for evaluating diagnostic techniques.
Chest, 102 (1992), pp. 553S-556S
[5]
Centers for Disease Control and Prevention.
Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP).
MMWR Morb Mortal Wkly Rep, 50 (2001), pp. 1-44
[6]
TC Horan.
National Nosocomial Infections Surveillance (NNIS) System.
Infect Control Hosp Epidemiol, 14 (1993), pp. 73-80
[7]
Tejerina E, Frutos-Vivar F, Apezteguia C, González M, Soto L, Abroug F, et al. Incidence and outcome of ventilator-associated pneumonia. Eur Resp J. In press 2004.
[8]
A Torres, R Aznar, JM Gatell, P Jimenes, J González, A Ferrer, et al.
Incidence, risk and prognosis factors of nosocomial pneumonia in mechanically ventilated patients.
Am Rev Respir Dis, 142 (1990), pp. 523-528
[9]
MJ Bonten, DC Bergmans, AW Ambergen, PW de Leeuw, S van der Geest, EE Stobberingh, et al.
Risk factors for pneumonia, and colonization of respiratory tract and stomach in mechanically ventilated ICU patients.
Am J Respir Crit Care Med, 154 (1996), pp. 1339-1346
[10]
DJ Cook, SD Walter, RJ Cook, LE Griffith, GH Guyatt, D Leasa, et al.
Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients.
Ann Intern Med, 129 (1998), pp. 433-440
[11]
JY Fagon, J Chastre, Y Domart, JL Trouillet, J Pierre, CV Darne.
Nosocomial pneumonia in patients receiving continuous mechanical ventilation: prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques.
Am Rev Respir Dis, 139 (1989), pp. 877-884
[12]
JL Vincent, DJ Bihari, PM Suter, HA Bruining, J White, MH Nicolas-Chanoin, et al.
The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee.
JAMA, 274 (1995), pp. 639-644
[13]
MS Niederman.
Pathogenesis of airway colonization: lessons learned from studies of bacterial adherence.
Eur Resp J, 7 (1994), pp. 1737-1740
[14]
A Torres, M El Ebiary, A Rano.
Respiratory infectious complications in the intensive care unit.
Clin Chest Med, 20 (1999), pp. 287-301
[15]
WG Johanson, AK Pierce, JP Sanford.
Changing pharyngeal bacterial flora of hospitalized patients: emergence of gram-negative bacilli.
N Engl J Med, 281 (1969), pp. 1137-1140
[16]
WG Johanson Jr, JJ Seidenfeld, R de los Santos, JJ Coalson, P Gómez.
Bacteriologic diagnosis of nosocomial pneumonia following prolonged mechanical ventilation.
Am Rev Respir Dis, 137 (1988), pp. 259-264
[17]
American Thoracic Society.
Hospital-acquired pneumonia in adults: diagnosis, assessment of severity, initial antimicrobial therapy, and preventive strategies. A consensus statement.
Am J Respir Crit Care Med, 153 (1995), pp. 1711-1725
[18]
MJM Bonten, CA Gaillard, FH van Tiel, HGW Smeets, S van de Geest, EE Stobberingh.
The stomach is not a source for colonization of the upper respiratory tract and pneumonia in ICU patients.
Chest, 105 (1994), pp. 878-884
[19]
S Ewig, A Torres, M El-Ebihari, N Fàbregas, C Hernández, J González, et al.
Bacterial colonization patterns in mechanically ventilated patients with traumatic and medical head injury. Incidence, risk factors, and association with ventilator-associated pneumonia.
Am J Respir Crit Care Med, 159 (1999), pp. 188-198
[20]
J Rello, M Sa Borges, H Correa, SR Leal, J Baraibar.
Variations in etiology of ventilator-associated pneumonia across four treatment sites: implications for antimicrobial prescribing practices.
Am J Respir Crit Care Med, 160 (1999), pp. 608-613
[21]
JL Trouillet, J Chastre, A Vaugnat, ML Joly-Guillou, D Combaux, ME Dombret.
Ventilator-associated pneumonia caused by potentially drug-resistant bacteria.
Am J Respir Crit Care Med, 157 (1998), pp. 531-539
[22]
J Rello, E Quintana, V Ausina, J Castella, M Luquin, A Net, et al.
Incidence, etiology and outcome of nosocomial pneumonia in mechanically ventilated patients.
Chest, 100 (1991), pp. 439-444
[23]
D Talon, B Mulin, C Rouget, P Bailly, M Thouverez, JF Viel.
Risks and routes for ventilator-associated pneumonia with Pseudomonas aeruginosa..
Am J Respir Crit Care Med, 157 (1998), pp. 978-984
[24]
D Bergmans, M Bonten, C Gaillard, P de Leeuw, F van Tiel, E Stobberingh, et al.
Clinical spectrum of ventilator-associated pneumonia caused by methicillin-sensitive Staphylococcus aureus..
Eur J Clin Microbiol Infect Dis, 15 (1996), pp. 437-445
[25]
S Crouch Brewer, RG Wunderink, CB Jones, KV Leeper Jr.
Ventilator associated pneumonia due to Pseudomonas aeruginosa..
Chest, 109 (1996), pp. 1019-1029
[26]
JY Fagon, J Chastre, Y Domart, JL Trouillet, C Gibert.
Mortality due to ventilator-associated pneumonia or colonization with Pseudomonas or Acinetobacter species: assessment by quantitative culture of samples obtained by a protected specimen brush.
Clin Infect Dis, 23 (1996), pp. 538-542
[27]
J Rello, E Díaz, M Roque, J Vallés.
Risk factors for developing pneumonia with 48 hours of intubation.
Am J Respir Crit Care Med, 155 (1999), pp. 1742-1746
[28]
DE Craven, MR Driks.
Pneumonia in the intubated patient.
Semin Respir Infect, 2 (1987), pp. 20-33
[29]
CM Luna, AJ Videla, J Matera, C Vay, A Famiglietti, P Vujacich, et al.
Blood cultures have limited value in predicting severity of illness and as a diagnostic tool in ventilator-associated pneumonia.
Chest, 116 (1999), pp. 1075-1084
[30]
N Fábregas, A Torres, M el-Ebiary, J Ramírez, C Hernández, J González, et al.
Histopathologic and microbiologic aspects of ventilator-associated pneumonia.
Anesthesiology, 84 (1996), pp. 760-771
[31]
MJ Richards, JR Edwards, DH Culver, RP Gaynes.
Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System.
Crit Care Med, 27 (1999), pp. 887-892
[32]
H Cabello, A Torres, R Celis, M El-Ebihari, J Puig de la Bellacasa, A Xaubet, et al.
Distal airway bacterial colonisation in healthy subjects and chronic lung diseases: a bronchoscopic study.
Eur Resp J, 10 (1997), pp. 1137-1144
[33]
JM Boyce, EB Mitchell Jr, JS Knapp, TM Buttke.
Nosocomial infections caused by a glucose metabolizing strain of Neisseria cinerea.
J Clin Microbiol, 21 (1985), pp. 1-3
[34]
AP Johnson.
The pathogenic potential of commensal species of Neisseria.
J Clin Pathol, 36 (1983), pp. 213-223
[35]
WE Kloos, TL Bannerman.
Update of clinical significance of coagulase-negative staphylococci.
Clin Microbiol Rev, 7 (1994), pp. 117-140
[36]
MR Pratter, RS Irwin.
Viridans streptococcal pulmonary parenchymal infections.
JAMA, 243 (1980), pp. 2515-2517
[37]
O Lambotte, JF Timsit, M Garouste-Orgeas, B Misset, A Benali, J Carlet.
The significance of distal bronchial samples with commensals in ventilator-associated pneumonia.
Chest, 122 (2002), pp. 1389-1399
[38]
CM Luna, C Vay, O Lucini, R Mosquera, H Mikulicz, A Videla, et al.
Ventilator-associated pneumonia (VAP) caused by non potentially pathogenic microorganisms (NPPMs).
Eur Resp J, 16 (2000), pp. 433S
[39]
M el-Ebiary, A Torres, N Fábregas, JP de la Bellacasa, J González, J Ramírez, et al.
Significance of the isolation of Candida species from respiratory samples in critically ill, non-neutropenic patients. An immediate postmortem histologic study.
Am J Respir Crit Care Med, 156 (1997), pp. 583-590
[40]
P Dore, R Robert, G Grollier, J Rouffineau, H Lanquetot, JM Charriere, et al.
Incidence of anaerobes in ventilator-associated pneumonia with use of a protected brush.
Am J Respir Crit Care Med, 153 (1996), pp. 1292-1298
[41]
P Jiménez, A Torres, R Rodríguez-Roisin, et al.
Incidence and etiology of pneumonia acquired during mechanical ventilation.
Crit Care Med, 17 (1989), pp. 882-885
[42]
CM Luna, P Vujacich, MS Niederman, C Vay, C Gherardi, J Matera, et al.
Impact of BAL data on the therapy and outcome of ventilatorassociated pneumonia.
Chest, 111 (1997), pp. 676-685
[43]
J Chastre, JL Trouillet, A Vuagnat, ML Joly-Guillou, H Clavier, MC Dombret, et al.
Nosocomial pneumonia in patients with acute respiratory distress syndrome.
Am Rev Respir Crit Care Med, 157 (1998), pp. 1165-1172
[44]
G Kampf, N Wischnewski, G Schulgen, M Schumacher, F Daschner.
Prevalence and risk factors for lower respiratory tract infections in German hospitals.
J Clin Epidemiol, 51 (1998), pp. 495-502
[45]
S Nseir, C Di Pompeo, P Pronnier, S Beague, T Onimus, F Saulnier, et al.
Nosocomial tracheobronchitis in mechanically ventilated patients: incidence, aetiology and outcome.
Eur Respir J, 20 (2002), pp. 1483-1489
[46]
FW Kahn, JM Jones.
Diagnosing bacterial respiratory infection by bronchoalveolar lavage.
J Infect Dis. 1996, 155 (1987), pp. 862-869
[47]
R Celis, A Torres, JH Gatell, M Almela, R Rodríguez Roisín, A Agustí Vidal.
Nosocomial pneumonia: a multivariate analysis of risk and prognosis.
Chest, 93 (1988), pp. 318-324
[48]
S Chevret, M Hemmer, J Carlet, M Langer.
Incidence and risk factors of pneumonia acquired in intensive care units. Results from a multicenter prospective study on 996 patients. European Cooperative Group on Nosocomial Pneumonia.
Intensive Care Med, 19 (1993), pp. 256-264
[49]
D Cook, M Kollef.
Risk factors for ICU-acquired pneumonia.
JAMA, 229 (1998), pp. 1605-1606
[50]
DE Craven, LM Kunches, V Kilinsky, DA Lichtenberg, BJ Make, WR McCabe.
Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation.
Am Rev Respir Dis, 133 (1986), pp. 792-796
[51]
MH Kollef.
Ventilator associated pneumonia. A multivariate analysis.
JAMA, 270 (1993), pp. 1965-1970
[52]
M Antonelli, ML Moro, O Capelli, RA de Blasi, RR D'Errico, G Conti, et al.
Risk factors for early onset pneumonia in trauma patients.
Chest, 105 (1994), pp. 224-228
[53]
J Rello, R Soñora, P Jubert, A Artigas, M Rué, J Vallés.
Pneumonia in intubated patients: role of respiratory airway care.
Am J Respir Crit Care Med, 154 (1996), pp. 111-115
[54]
N Joshi, AR Localio, BH Hamory.
A predictive risk index for nosocomial pneumonia in the intensive care unit.
Am J Med, 93 (1992), pp. 135-142
[55]
MH Kollef, B von Harz, D Prentice, SD Shapiro, P Silver, R St. John, et al.
Patient transport from intensive care increases the risk of developing ventilator-associated pneumonia.
Chest, 112 (1997), pp. 765-773
[56]
J Baraibar, H Correa, D Mariscal, M Gallego, J Vallés, J Rello.
Risk factors for infection by Acinetobacter baumannii in intubated patients with nosocomial pneumonia.
Chest, 112 (1997), pp. 1050-1054
[57]
J Rello, V Ausina, M Ricart, J Castella, G Prats.
Impact of previous antimicrobial therapy on the etiology and outcome of ventilatorassociated pneumonia.
Chest, 104 (1993), pp. 1230-1235
[58]
A Tejada Artigas, S Bello Dronda, E Chacón Vallés, J Muñoz Marco, MC Villuendas Usón, P Figueras, et al.
Risk factors for nosocomial pneumonia in critically ill trauma patients.
Crit Care Med, 29 (2001), pp. 304-309
[59]
R D'Amico, S Pifferi, C Leonetti, V Torri, A Tinazzi, A Liberati.
Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials.
BMJ, 316 (1998), pp. 1275-1285
[60]
J Montejo, G Teodoro, J Acosta, S Ruiz-Santana, M Planas, A García de Lorenzo, for the Nutritional and Metabolic Working Group of the Spanish Society of Intensive Care Medicine and Coronary Units, et al.
Multicenter, prospective, randomized, single-blind study comparing the efficacy and gastrointestinal complications of early jejunal feeding with gastric feeding in critical ill patients.
Crit Care Med, 30 (2002), pp. 796-800
[61]
MA Montecalvo, KA Steger, HW Farber, BF Smith, RC Dennis, GF Fitzpatrick, et al.
Nutritional outcome and pneumonia in critical care patients, randomized to gastric versus jejunal tube feeding. The Critical Care Research Team.
Crit Care Med, 20 (1992), pp. 1377-1387
[62]
RM Strong, SC Condon, MR Solinger, BN Namihas, LA Ito-Wang, JE Leuty.
Equal aspiration rates from postpylorus and intragastric placed small bore nasoenteric feeding tubes: a randomized, prospective study.
J Parenteral Nutr, 16 (1992), pp. 59-63
[63]
A Kropec, G Schulgen, H Just, K Geiger, M Schumacher, F Daschner.
Scoring system for nosocomial pneumonia in ICUs.
Intensive Care Med, 22 (1996), pp. 1155-1161
[64]
P Mosconi, M Langer, M Cigada, M Mandelli.
Epidemiology and risk factors of pneumonia in critically ill patients.
Eur J Epidemiol, 7 (1991), pp. 320-327
[65]
A Torres, GM Gatell, E Aznar, M el-Ebiary, J Puig de la Bellacasa, J González, et al.
Re-Intubation increases the risk of nosocomial pneumonia in patients needing mechanical ventilation.
Am J Respir Crit Care Med, 152 (1995), pp. 137-141
[66]
EH Ibrahim, L Tracy, C Hill, VJ Fraser, MH Kollef.
The occurrence of ventilator-associated pneumonia in a community hospital: risk factors and clinical outcomes.
Chest, 120 (2001), pp. 555-561
[67]
JL Rodríguez, SM Steinberg, FA Luchetti, KJ Gibbons, PA Taheri, LM Flint.
Early tracheostomy for primary airway management in the surgical critical care setting.
Surgery, 108 (1990), pp. 655-659
[68]
HJ Sugerman, L Wolfe, MD Pasquale, FB Rogers, KF O'Malley, M Knudson, et al.
Multicenter, randomized, prospective trial of early tracheostomy.
J Trauma, 43 (1997), pp. 741-747
[69]
L Holzapfel, C Chastang, G Demingeon, J Bohe, B Piralla, A Coupry.
A randomized study assessing the systematic search for maxillary sinusitis in nasotracheally mechanically ventilated patients. Influence of nosocomial maxillary sinusitis on the occurrence of ventilatorassociated pneumonia.
Am J Respir Crit Care Med, 159 (1999), pp. 695-701
[70]
JJ Rouby, P Laurent, M Gosnach, E Cambau, G Lamas, A Zouaoui, et al.
Risk factors and clinical relevance of nosocomial maxillary sinusitis in the critically ill.
Am J Respir Crit Care Med, 150 (1994), pp. 776-783
[71]
MH Kollef.
Epidemiology and risk factors for nosocomial pneumonia. Emphasis on prevention.
Clin Chest Med, 20 (1999), pp. 653-670
[72]
NJ Fernández Cavalcante, ML Sandeville, EA Servolo Madeiros.
Incidence of and risk factors for nosocomial pneumonia in patients with tetanus.
Clin Infect Dis, 33 (2001), pp. 1842-1846
[73]
J Rello, V Ausina, M Ricart, C Puzo, E Quintana, A Net.
Risk factors for infection by Pseudomonas aeruginosa in patients with ventilatorassociated pneumonia.
Intensive Care Med, 20 (1994), pp. 193-198
[74]
S Hanes, K Demirkan, E Tolley, B Boucher, M Croce, G Wood, et al.
Risk factors for late-onset nosocomial pneumonia caused by Stenotrophomonas maltophilia in critically ill trauma patients.
Clin Infect Dis, 35 (2002), pp. 228-235
[75]
J Rello, A Torres, M Ricart, J Valles, J González, A Artigas, et al.
Ventilator-associated pneumonia by Staphylococcus aureus: comparison of methicillin-resistant and methicillin-sensitive episodes.
Am J Respir Crit Care Med, 150 (1994), pp. 1545-1549
[76]
C Delclaux, E Roupie, F Blot, L Brochard, F Lemaire, C Brun Buisson.
Lower respiratory tract colonization and infection during severe acute respiratory distress syndrome: incidence and diagnosis.
Am J Respir Crit Care Med, 156 (1997), pp. 1092-1098
[77]
CP Andrews, JJ Coalson, JD Smith, WG Johanson.
Diagnosis of nosocomial bacterial pneumonia in acute diffuse lung injury.
Chest, 80 (1981), pp. 254-258
[78]
Estenssoro E, Dubin A, Laffaire E, Canales H, Sáenz G, Moseinco M, et al. Neumonía asociada al respirador en el síndrome de distrés respiratorio agudo. Proceedings of the XII Congreso Argentino de Terapia Intensiva: Rosario, Santa Fe; 2001.
[79]
TR Martin, BP Pistorese, LD Hudson, RJ Maunder.
The function of lung and blood neutrophils in patients with the adult respiratory distress syndrome. Implications for the pathogenesis of lung infections.
Am Rev Respir Dis, 144 (1991), pp. 254-262
[80]
S Chollet-Martin, B Jourdian, C Gibert, C Elbim, J Chastre, MA Gougerot-Pocidalo.
Interactions between neutrophils and cytokines in blood and alveolar spaces during ARDS.
Am J Respir Crit Care Med, 154 (1996), pp. 594-601
[81]
P Markowicz, M Wolf, K Djeaïni, Y Cohen, J Chastre, C Delclaux, et al.
The ARDS Study Group. Multicenter prospective study of ventilator-associated pneumonia during acute respiratory distress syndrome.
Am J Respir Crit Care Med, 161 (2000), pp. 1942-1948
[82]
KR Sutherland, KP Steinberg, RJ Maunder, JA Milberg, DL Allen, LD Hudson.
Pulmonary infection during the acute respiratory distress syndrome.
Am J Crit Respir Crit Care Med, 152 (1995), pp. 550-556
[83]
DL George, PS Falk, RG Wunderink, KV Leeper Jr, GU Meduri, EL Steere, et al.
Epidemiology of ventilator-acquired pneumonia based on protected bronchoscopic sampling.
Am J Respir Crit Care Med, 158 (1998), pp. 1839-1847
[84]
RC Bell, JJ Coalson, JD Smith, WG Johanson.
Multiple organ system failure and infection in adult respiratory distress syndrome.
Ann Intern Med, 99 (1983), pp. 293-298
[85]
TT Bauer, A Torres.
Acute respiratory distress syndrome and nosocomial pneumonia.
Thorax, 54 (1999), pp. 1036-1040
[86]
J Chastre, JY Fagon.
Ventilator-associated pneumonia.
Am J Respir Crit Care Med, 165 (2002), pp. 867-903
[87]
DK Heyland, DJ Cook, L Griffith, SP Keenan, C Brun-Buisson.
The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient.
Am J Respir Crit Care Med, 159 (1999), pp. 1249-1256
[88]
DE Craven, KA Steger.
Nosocomial pneumonia in mechanically ventilated adult patients: epidemiology and prevention in 1996.
Semin Respir Infect, 11 (1996), pp. 32-53
[89]
RM Stevens, D Teres, JJ Skillman, DS Feingold.
Pneumonia in an intensive care unit. A 30-month experience.
Arch Intern Med, 134 (1974), pp. 106-111
[90]
JF Timsit, S Chevret, J Valcke, B Misset, B Renaud, FW Goldstein, et al.
Mortality of nosocomial pneumonia in ventilated patients: influence of diagnostic tools.
Am J Respir Crit Care Med, 154 (1996), pp. 116-123
[91]
CP Craig, S Connelly.
Effect of intensive care unit nosocomial pneumonia on duration of stay and mortality.
Am J Infect Control, 12 (1984), pp. 233-238
[92]
JY Fagon, J Chastre, AJ Hance, P Montravers, A Novara, C Gibert.
Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay.
Am J Med, 94 (1993), pp. 281-288
[93]
KM Cunnion, DJ Weber, WE Broadhead, LC Hanson, CF Pieper, WA Rutala.
Risk factors for nosocomial pneumonia: comparing adult critical-care populations.
Am J Respir Crit Care Med, 153 (1996), pp. 158-162
[94]
AM Baker, JW Meredith, EF Haponik.
Pneumonia in intubated trauma patients. Microbiology and outcomes.
Am J Respir Crit Care Med, 156 (1996), pp. 343-943
[95]
L Papazian, F Bregeon, X Thirion, R Gregoire, P Saux, JP Denis, et al.
Effect of ventilator-associated pneumonia on mortality and morbidity.
Am J Respir Crit Care Med, 154 (1996), pp. 91-97
[96]
N Bercault, T Boulain.
Mortality rate attributable to ventilatorassociated nosocomial pneumonia in an adult intensive care unit: a prospective case-control study.
Crit Care Med, 29 (2001), pp. 2303-2309
[97]
MH Kollef, KR Bock, RD Richards, ML Hearns.
The safety and diagnostic accuracy of minibronchoalveolar lavage in patients with suspected ventilator-associated pneumonia.
Ann Intern Med, 122 (1995), pp. 743-748
[98]
JJ Seidenfeld, DF Pohl, RC Bell, GD Harris, WG Johanson Jr.
Incidence, site, and outcome of infections in patients with the adult respiratory distress syndrome.
Am Rev Respir Dis, 134 (1986), pp. 12-16
[99]
CJ Randle Jr, LR Frankel, MD Amylon.
Identifying early predictors of mortality in pediatric patients with acute leukemia and pneumonia.
Chest, 109 (1996), pp. 457-461
[100]
IS Lossos, R Breuer, R Or, N Strauss, H Elishoov, E Naparstek, et al.
Bacterial pneumonia in recipients of bone marrow transplantation. A five-year prospective study.
Transplantation, 15 (1995), pp. 672-678
[101]
EW Ely, AM Baker, DP Dunagan, HL Burke, AC Smith, PT Kelly, et al.
Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously.
N Engl J Med, 335 (1996), pp. 1864-1869
[102]
MJ Bonten, AH Froon, CA Gaill ard, JW Greve, PW Leeuw, M Drent, et al.
The systemic inflammatory response in the development of ventilator-associated pneumonia.
Am J Respir Crit Care Med, 156 (1997), pp. 1105-1113
[103]
F Álvarez-Lerma.
Modifications of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit. ICU-Acquired Pneumonia Study Group.
Intensive Care Med, 22 (1996), pp. 387-394
[104]
JM Sánchez-Nieto, A Torres, F García-Cordoba, M el-Ebiary, A Carrillo, J Ruiz, et al.
Impact of invasive and noninvasive quantitative culture sampling on outcome of ventilator-associated pneumonia: a pilot study.
Am J Respir Crit Care Med, 157 (1998), pp. 371-376
[105]
M Ruiz, A Torres, S Ewig, MA Marcos, A Alcón, R Lledó, et al.
Noninvasive versus invasive microbial investigation in ventilator-associated pneumonia: evaluation of outcome.
Am J Respir Crit Care Med, 162 (2000), pp. 119-125
[106]
H Dupont, H Mentec, JP Sollet, G Bleichner.
Impact of appropriateness of initial antibiotic therapy on the outcome of ventilator-associated pneumonia.
Intensive Care Med, 27 (2001), pp. 355-362
[107]
P Moine, JF Timsit, A De Lassence, G Troche, JP Fosse, C Alberti, et al.
The OUTCOMEREA study group. Mortality associated with lateonset pneumonia in the intensive care unit: results of a multi-center cohort study.
Intensive Care Med, 28 (2002), pp. 154-163
[108]
GU Meduri, GL Mauldin, RG Wunderink, KV Leeper Jr, CB Jones, E Tolley, et al.
Causes of fever and pulmonary densities in patients with clinical manifestations of ventilator associated pneumonia.
Chest, 109 (1994), pp. 221-235
[109]
N Fábregas, S Ewig, A Torres, M el-Ebiary, J Ramírez, J Puig de la Bellacasa, et al.
Clinical diagnosis of ventilator associated pneumonia revisited: comparative validation using immediate postmortem lung biopsies.
Thorax, 54 (1999), pp. 867-873
[110]
J Pugin, R Auckenthaler, N Mili, JP Janssens, PD Lew, PM Suter.
Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic “blind” bronchoalveolar lavage fluid.
Am Rev Respir Dis, 143 (1991), pp. 1121-1129
[111]
N Singh, P Rogers, CW Atwood, MM Wagener, VL Yu.
Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription.
Am J Respir Crit Care Med, 162 (2000), pp. 505-511
[112]
CM Luna, D Blanzaco, MS Niederman, W Matarucco, NC Baredes, P Desmery, et al.
Resolution of ventilator-associated pneumonia: prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome.
Crit Care Med, 31 (2003), pp. 676-682
[113]
A Torres, M el-Ebiary, L Padró, J González, J Puig de la Bellacasa, J Ramírez, et al.
Validation of different techniques for the diagnosis of ventilator associated pneumonia. Comparison with immediately postmortem pulmonary biopsy.
Am J Respir Crit Care Med, 149 (1994), pp. 324-331
[114]
CS Garrard, CD A'Court.
The diagnosis of pneumonia in the critically ill.
Chest, 108 (1995), pp. 15S-25S
[115]
PJW Dennesen, AJAM van der Ven, AJH Kessels, G Ramsay, MJM Bonten.
Resolution of infectious parameters after antimicrobial therapy in patients with ventilator-associated pneumonia.
Am J Respir Crit Care Med, 163 (2001), pp. 1371-1375
[116]
RG Wunderink.
Radiologic diagnosis of ventilator-associated pneumonia.
Chest, 117 (2000), pp. 188S-190S
[117]
N Fábregas, A Torres.
Aspectos histopatológicos y microbiológicos de la neumonía asociada a la ventilación mecánica.
Infecciones respiratorias en UCI, pp. 154-168
[118]
MS Lefcoe, GA Fox, DJ Leasa, RK Sparrow, DG McCormack.
Accuracy of portable chest radiography in the critical care setting. Diagnosis of pneumonia based on quantitative cultures obtained from protected brush catheter.
Chest, 105 (1994), pp. 885-887
[119]
HT Winer-Muram, SA Rubin, JV Ellis, SG Jennings, KL Arheart, RG Wunderink, et al.
Pneumonia and ARDS in patients receiving mechanical ventilation: diagnostic accuracy of chest radiography.
Radiology, 188 (1993), pp. 479-485
[120]
M Ferrer, A Torres, J González, J Puig de la Bellacasa, M el-Ebiary, M Roca, et al.
Utility of selective digestive decontamination in mechanically ventilated patients.
Ann Inter Med, 120 (1994), pp. 389-395
[121]
GU Meduri.
Ventilator associated pneumonia in patients with respiratory failure. A diagnosis approach.
Chest, 97 (1990), pp. 1208-1219
[122]
L Beydon, M Saada, N Liu, JP Becquemin, A Harf, F Bonnet, et al.
Can portable chest x-ray examination accurately diagnose lung consolidation after major abdominal surgery? A comparison with computed tomography scan.
Chest, 102 (1992), pp. 1697-1703
[123]
HT Winer-Muram, RM Steiner, JW Gurney, R Shah, SG Jennings, KL Arheart, et al.
Ventilator-associated pneumonia in patients with adult respiratory distress syndrome: CT evaluation.
Radiology, 208 (1998), pp. 193-200
[124]
VS Baselski, RG Wunderink.
Bronchoscopic diagnosis of pneumonia.
Clin Microbiol Rev, 7 (1994), pp. 533-558
[125]
GW Waterer, RG Wunderink.
Controversies in the diagnosis of ventilator-acquired pneumonia.
Med Clin N Am, 85 (2001), pp. 1565-1581
[126]
SC Predari, L Barrera, MB Lasala.
Diagnóstico microbiológico de los distintos materiales.
Microbiología clínican,
[127]
DJ Cook, L Mandell.
Endotracheal aspiration in the diagnosis of ventilator-associated pneumonia.
Chest, 117 (2000), pp. 195S-197S
[128]
B Jourdain, A Novara, ML Joly-Guillou, MC Dombret, S Calvat, JL Trouillet, et al.
Role of quantitative cultures of endotracheal aspirates in the diagnosis of nosocomial pneumonia.
Am J Respir Crit Care Med, 152 (1995), pp. 241-246
[129]
CH Marquette, H Georges, F Wallet, P Ramon, F Saulnier, R Neviere, et al.
Diagnostic efficiency of endotracheal aspirates with quantitative bacterial cultures in intubated patients with suspected pneumonia. Comparison with the protected specimen brush.
Am Rev Respir Dis, 148 (1993), pp. 138-144
[130]
R Baughman.
Protected-specimen brush technique in the diagnosis of ventilator-associated pneumonia.
Chest, 117 (2000), pp. 293S-306S
[131]
J Solé Violán, J Arroyo Fernández, A Bordes Benítez, JA Cardeñosa Cendero, F Rodríguez de Castro.
Impact of quantitative diagnostic techniques in the management and outcome of mechanically ventilated patients with suspected pneumonia.
Crit Care Med, 28 (2000), pp. 2737-2741
[132]
DK Heyland, DJ Cook, J Marshall, M Heule, B Guslits, J Lang, et al.
The clinical utility of invasive diagnostic techniques in the setting of ventilator-associated pneumonia. Canadian Critical Care Trials Group.
Chest, 115 (1999), pp. 1076-1084
[133]
JY Fagon, J Chastre, M Wolf, C Gervais, S Parer-Aubas, F Stéphan, et al.
Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia, a randomized trial.
Arch Int Med, 132 (2000), pp. 621-630
[134]
M Iregui, S Ward, G Sherman, V Fraser, M Kollef.
Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia.
Chest, 122 (2002), pp. 262-268
[135]
MH Kollef, S Ward.
The influence of mini-BAL cultures on patient outcomes: implications for the antibiotic management of ventilator-associated pneumonia.
Chest, 113 (1998), pp. 412-420
[136]
J Chastre, M Wolff, J-Y Fagon, S Chevret, D Wermert, E Clementy, et al.
Comparison of 8 vs 15 days of antibiotic therapy for ventilatorassociated pneumonia in adults, a randomized trial.
JAMA, 290 (2003), pp. 2588-2598
[137]
AC Fluit, CL Wielders, J Verhoef, FJ Schmitz.
Epidemiology and susceptibility of 3,051 Staphylococcus aureus isolates from 25 university hospitals participating in the European SENTRY study.
J Clin Microbiol, 39 (2001), pp. 3727-3732
[138]
DJ Diekema, MA Pfaller, FJ Schmitz, J Smayevsky, J Bell, RN Jones, SENTRY Participants Group, et al.
Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997-1999.
Clin Infect Dis, 32 (2001), pp. 114-132
[139]
SK Fridkin, J Hageman, LK McDougal, J Mohammed, WR Jarvis, TM Perl, et al.
Vancomycin-Intermediate Staphylococcus aureus Epidemiology Study Group. Epidemiological and microbiological characterization of infections caused by Staphylococcus aureus with reduced susceptibility to vancomycin, United States, 1997-2001.
Clin Infect Dis, 36 (2003), pp. 429-439
[140]
Vancomycin-resistant Staphylococcus aureus-Pennsylvania, 2002.
MMWR Morb Mortal Wkly Rep, 51 (2002), pp. 902
[141]
K Hiramatsu.
Vancomycin-resistant Staphylococcus aureus: a new model of antibiotic resistance.
Lancet Infect Dis, 1 (2001), pp. 147-155
[142]
AS Haddadin, SA Fappiano, PA Lipsett.
Methicillin resistant Staphylococcus aureus (MRSA) in the intensive care unit.
Postgrad Med J, 78 (2002), pp. 385-392
[143]
ADE Studemeister, JP Quinn.
Selective imipenem resistance in Pseudomonas aeruginosa associated with diminished outer membrane permeability.
Antimicrob Agents Chemother, 32 (1988), pp. 1267-1268
[144]
KH Mayer.
Review of epidemic aminoglycoside resistance worldwide.
Am J Med, 50 (1986), pp. 56-64
[145]
WA Woodruff, RE Hancock.
Construction and characterization of Pseudomonas aeruginosa protein F-deficient mutants after in vitro and in vivo insertion mutagenesis of the cloned gene.
J Bacteriol, 170 (1988), pp. 2592-2598
[146]
N Masuda, E Sakagawa, S Ohya, N Gotoh, H Tsujimot, T Nishino.
Substrate specificities of MexCD-OprJ and MexXY-OprM efflux pumps in Pseudomonas aeruginosa..
Antimicrob Agents Chemother, 44 (2000), pp. 3322-3327
[147]
S Jalal, B Wretlind.
Mechanisms of quinolone resistance in clinical strains of Pseudomonas aeruginosa..
Microb Drug Resist, 4 (1998), pp. 257-261
[148]
DM Livermore.
Beta-lactamases in laboratory and clinical resistance.
Clin Microbiol Rev, 8 (1995), pp. 557-584
[149]
M Hilf, VL Yu, J Sharp, JJ Zuravleff, JA Korvick, RR Muder.
Antibiotic therapy for Pseudomonas aeruginosa bacteremia: outcome correlations in a prospective study of 200 patients.
Am J Med, 87 (1989), pp. 540-546
[150]
A Cometta, JD Baumgartner, D Lew, W Zimmerli, D Pittet, P Chopart, et al.
Prospective randomized comparison of imipenem monotherapy with imipenem plus netilmicin for treatment of severe infections in non-neutropenic patients.
Antimicrob Agents Chemother, 38 (1994), pp. 1309-1313
[151]
DM Livermore.
Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: our worst nightmare?.
Clin Infect Dis, 34 (2002), pp. 634-640
[152]
DH Hamer.
Treatment of nosocomial pneumonia and tracheobronchitis caused by multidrug-resistant Pseudomonas aeruginosa with aerosolized colistin.
Am J Respir Crit Care Med, 162 (2000), pp. 328-330
[153]
AS Levin, AA Barone, J Penco, MV Santos, IS Marinho, EA Arruda, et al.
Intravenous colistin as therapy of nosocomial infections caused by multi-drug resistant Pseudomonas aeruginosa and Acinetobacter baumannii..
Clin Infect Dis, 28 (1999), pp. 1008-1011
[154]
AC Gales, RN Jones, KR Forward, J Liñares, J Verhoel.
Emerging importance of multi-drug resistant Acinetobacter species and Stenotrophomonas maltophilia as a pathogen in seriously ill patients: geographic patterns, epidemiological features and trends in the SENTRY antimicrobial surveillance program (1997-1999).
Clin Inf Dis, 32 (2001), pp. 104-113
[155]
CD Poulos, S Matsumura, BM Willey, DE Low, A McGeer.
In vitro activities of antimicrobial combinations against Stenotrophomonas (Xanthomonas) maltophilia.
Antimicrob Agents Chemother, 39 (1995), pp. 2220-2223
[156]
HS Sader, RN Jones, S Andrade-Baiocchi, DJ Biedenbach, SENTRY participants group.
Four-year evaluation of frequency of occurrence and antimicrobial susceptibility patterns of bacteria from bloodstream infections in Latin American medical centers.
Diagn Microbiol Infect Dis, 44 (2002), pp. 273-280
[157]
PL Winokur, R Canton, JM Casellas, N Legakis.
Variations in the prevalence of strains expressing an extended-spectrum beta-lactamase phenotype and characterization of isolates from Europe, the Americas, and Western Pacific region.
Clin Infect Dis, 32 (2001), pp. 94-103
[158]
JE McGowan.
Antimicrobial resistance in hospital organisms and its relation to antibiotic use.
Rev Infect Dis, 5 (1983), pp. 1033-1048
[159]
KS Meyer, C Urban, JA Eagan, BJ Berger, JJ Rahal.
Nosocomial outbreak of Klebsiella infection resistant to late-generation cephalosporins.
Ann Intern Med, 119 (1993), pp. 353-358
[160]
HC Neu.
The crisis in antibiotic resistance.
Science, 257 (1992), pp. 1064-1073
[161]
SK Fridkin, RP Gaynes.
Antimicrobial resistance in intensive care units.
Clin Chest Med, 20 (1999), pp. 303-316
[162]
Subcomisión de Antimicrobianos de SADEBAC, División AAM y Grupo SIR. Relevamiento nacional de microorganismos de origen hospitalario aislados de BAL y su perfil de resistencia a los antibióticos. Subcomisión de Antimicrobianos de SADEBAC, División AAM y Grupo SIR. Actas de Jornadas SADET; 2002. REDWHONET, 2002.
[163]
JJ Schentag, KK Gilliland, JA Paladino.
What have we learned from pharmacokinetic and pharmacodynamic theories?.
Clin Infect Dis, 32 (2001), pp. 39-46
[164]
DE Fry.
The importance of antibiotic pharmacokinetics in critical illness.
Am J Surg, 172 (1996), pp. 20S-25S
[165]
DR Baldwin, D Honeybourne, R Wise.
Pulmonary disposition of antimicrobial agents: in vivo observations and clinical relevance.
Antimicrob Agents Chemother, 36 (1992), pp. 1176-1180
[166]
DR Baldwin, D Honeybourne, R Wise.
Pulmonary disposition of antimicrobial agents: methodological considerations.
Antimicrob Agents Chemoter, 36 (1992), pp. 1171-1175
[167]
M Cruciani, G Gatti, L Lazzarini, G Furlan, G Broccali, M Malena, et al.
Penetration of vancomycin into human lung tissue.
J Antimicrob Chemother, 38 (1996), pp. 865-869
[168]
D Honeybourne, DR Baldwin.
The site concentrations of antimicrobial agents in the lung.
J Antimicrob Chemother, 30 (1992), pp. 249-260
[169]
Avellaneda B, Juárez J, de Mier C, Rodríguez H, Lasala MB, Foccoli A, et al. Sensibilidad antibiótica en neumococos resistentes (NRP) y sensibles a penicilina (NSP). Actas de XXIX Congreso Argentino de Medicina Respiratoria; 2001, noviembre 25-28; Buenos Aires.
[170]
MP Fink, DR Snydman, MS Niederman, KV Leeper, RH Johnson, SO Heard, et al.
Treatment of severe pneumonia in hospitalized patients: results of multicenter, randomized, double blind trial comparing intravenous ciprofloxacin with imipenem-cilastatin. The Severe Pneumonia Study Group.
Antimicrob Agents Chemother, 38 (1994), pp. 547-557
[171]
EORTC International Antimicrobial Therapy Cooperative Group.
Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia.
N Engl J Med, 317 (1987), pp. 1692-1698
[172]
RJ Mangi, J Ryan, C Berenson, T Greco, M Simms, G Thornton, et al.
Cefoperazone versus ceftazidime monotherapy of nosocomial pneumonia.
Am J Med, 85 (1988), pp. 44-48
[173]
RJ Mangi, KM Peccerrillo, J Ryan, C Berenson, T Greco, G Thornton, et al.
Cefoperazone versus ceftriaxone monotherapy of nosocomial pneumonia.
Diagn Microbiol Infect Dis, 15 (1992), pp. 441-447
[174]
JA Korvick, CS Bryan, B Farber, TR Beam Jr, L Schenfeld, RR Muder, et al.
Prospective observational study of Klebsiella bacteriemia in 230 patients: outcome for antibiotic combinations versus monotherapy.
Antimicrob Agents Chemoter, 36 (1992), pp. 2639-2644
[175]
JA Paladino, HE Sperry, JM Backes, JA Gelber, DJ Serrianne, TJ Cumbo, et al.
Clinical and economic evaluation of oral ciprofloxacin after an abbreviated course of intravenous antibiotics.
Am J Med, 91 (1991), pp. 21-32
[176]
CL Wu, Die Yang, NY Wang, HT Kuo, PZ Chen.
Quantitative culture of endotracheal aspirates in the diagnosis of ventilator-associated pneumonia in patients with treatment failure.
Chest, 122 (2002), pp. 662-668
[177]
K Davis Jr, JA Johannigman, RS Campbell, A Marraccini, FA Luchette, SB Frame, et al.
The acute effects of body position strategies and respiratory therapy in paralyzed patients with acute lung injury.
Crit Care, 5 (2001), pp. 81-87
[178]
DE Craven, KA Steger.
Ventilator-associated bacterial pneumonia: challenges in diagnosis, treatment, and prevention.
New Horiz, 6 (1998), pp. S30-S45
[179]
M Wysocki, M Antonelli.
Noninvasive mechanical ventilation in acute hypoxemic respiratory failure.
Eur Respir J, 17 (2001), pp. 1271-1281
[180]
JT Wang, CT Fang, YC Chen, SC Chang.
Necessity of a loading dose when using vancomycin in critically ill patients.
J Antimicrob Chemother, 47 (2001), pp. 246
[181]
A di Filippo, AR de Gaudio, A Novelli, E Paternostro, C Pelagatti, P Livi, et al.
Continuous infusion of vancomycin in methicillinresistant Staphylococcus infection.
Chemotherapy, 44 (1998), pp. 63-68
[182]
MH Kollef.
Hospital-acquired pneumonia and de-escalation of antimicrobial treatment.
Crit Care Med, 29 (2001), pp. 1473-1475
[183]
MH Kollef, G Sherman, S Ward, VJ Fraser.
Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients.
Chest, 115 (1999), pp. 462-474
[184]
G Hoffken, MS Niederman.
Nosocomial pneumonia: the importance of a de-escalating strategy for antibiotic treatment of pneumonia in the ICU.
Chest, 122 (2002), pp. 2183-2196
[185]
LB Palmer, GC Smaldone, SR Simon, TG O'Riordan, A Cuccia.
Aerosolized antibiotics in mechanically ventilated patients: delivery and response.
Crit Care Med, 26 (1998), pp. 31-39
[186]
RJ Kuhn.
Formulation of aerosolized therapeutics.
Chest, 120 (2001), pp. 94-98
[187]
T Todisco, A Eslami, S Baglioni, T Sposini, C Tascini, E Sommer, et al.
Basis for nebulized antibiotics: droplet characterization and in vitro antimicrobial activity versus Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa..
J Aerosol Med, 13 (2000), pp. 11-16
[188]
GS Itokazu, RA Weinstein.
Aerosolized antimicrobials: another look.
Crit Care Med, 26 (1998), pp. 5-6
[189]
BW Ramsey, MS Pepe, JM Quan, KL Otto, AB Montgomery, J Williams-Warren, the Cystic Fibrosis Inhaled Tobramycin Study Group, et al.
Intermittent administration of inhaled tobramycin in patients with cystic fibrosis.
N Engl J Med, 340 (1999), pp. 23-30
[190]
J Lynch.
Hospital acquired pneumonia.
Chest, 119 (2001), pp. 373S-384S
[191]
F Álvarez Lerma, Serious Infection Study Group.
Efficacy of meropenem as monotherapy in the treatment of ventilator-associated pneumonia.
J Chemother, 13 (2001), pp. 70-81
[192]
E Prats, J Dorca, M Pujol, L García, B Barreiro, R Verdaguer, et al.
Effects of antibiotics on protected specimen brush sampling in ventilator-associated pneumonia.
Eur Respir J, 19 (2002), pp. 944-951
[193]
EH Ibrahim, S Ward.
Experience with clinical guideline for the treatment of ventilator-associated pneumonia.
Crit Care Med, 29 (2001), pp. 1109-1115
[194]
nternational Conference for the Development of Consensus on the Diagnosis and Treatment of Ventilator-Associated Pneumonia.
Chest, 120 (2001), pp. 955-970
[195]
MJ Bonten, DC Bergmans, EE Stobberingh, S van der Geest, PW de Leeuw, FH van Tiel, et al.
Implementation of bronchoscopic techniques in the diagnosis of ventilator-associated pneumonia to reduce antibiotic use.
Am J Respir Crit Care Med, 156 (1997), pp. 1820-1824
[196]
WA Craig, DR Andes.
Parenteral versus oral antibiotic therapy.
Med Clin North Am, 79 (1995), pp. 497-508
[197]
RR MacGregor, AL Graziani.
Oral administration of antibiotics: a rational alternative to the parenteral route.
Clin Infect Dis, 24 (1997), pp. 457-467
[198]
S Ahkee, S Smith, D Newman, W Ritter, J Burke, JA Ramírez.
Early switch from intravenous to oral antibiotics in hospitalized patients with infections: a 6-month prospective study.
Pharmacotherapy, 17 (1997), pp. 569-575
[199]
F Barcenilla, E Gasco, J Rello, L Álvarez-Rocha.
Antibacterial treatment of invasive mechanical ventilation-associated pneumonia.
Drugs Aging, 18 (2001), pp. 189-200
[200]
F Arancibia, TT Bauer, S Ewig, J Mensa, J González, MS Niederman, et al.
Community-acquired pneumonia due to gram-negative bacteria and Pseudomonas aeruginosa: incidence, risk, and prognosis.
Arch Intern Med, 162 (2002), pp. 1849-1858
[201]
K Bui, R Quintiliani.
Antimicrobial switch therapy.
Conn Med, 62 (1998), pp. 665-668
[202]
BA Cunha.
Intravenous-to-oral antibiotic switch therapy. A cost effective approach.
Postgrad Med, 101 (1997), pp. 111-112
[203]
CM Hitt, CH Nightingale, R Quintiliani, DP Nicolau.
Streamlining antimicrobial therapy for lower respiratory tract infections.
Clin Infect Dis, 24 (1997), pp. 231-237
[204]
JC Pereira Gomes, WL Pedreira Jr, EMPA Araújo, FG Soriano, EM Negri, L Antonîngelo, et al.
Impact of BAL in the management of pneumonia with treatment failure.
Chest, 118 (2000), pp. 1739-1746
[205]
B Souweine, B Veber, JP Bedos, B Gachot, MC Dombret, B Regnier, et al.
Diagnostic accuracy of protected specimen brush and bronchoalveolar lavage in nosocomial pneumonia: impact of previous antimicrobial treatments.
Crit Care Med, 26 (1998), pp. 236-244
[206]
DR Hess.
The evidence for secretion clearance techniques.
Respir Care, 46 (2001), pp. 1276-1293
[207]
C Wallis, A Prasad.
Who needs chest physiotherapy? Moving from anecdote to evidence.
Arch Dis Child, 80 (1999), pp. 393-397
[208]
K Stiller.
Physiotherapy in intensive care. Towards an evidence based practice.
Chest, 118 (2000), pp. 1801-1813
[209]
LH Kirilloff, GR Ownens, RM Rogers, MC Mazzocco.
Does chest physical therapy work?.
Chest, 88 (1985), pp. 436-444
[210]
K Horiuchi, D Jordan, D Cohen, MC Kemper, C Weissman.
Insights into the increased oxygen demand during chest physiotherapy.
Crit Care Med, 25 (1997), pp. 1347-1351
[211]
P Klein, M Kemper, C Weissman, SH Rosenbaum, J Askanazi, AI Hyman.
Attenuation of the hemodynamic responses to chest physical therapy.
Chest, 93 (1988), pp. 38-42
[212]
K Dong-Soon, R Jin-Sook, K Won-Dong.
Closing volume influences the postural effect on oxygenation in unilateral lung disease.
Am J Respir Crit Care Med, 161 (2000), pp. 1957-1962
[213]
J Ibáñez, JM Raurich, R Abizanda, R Claramonte, P Ibáñez, J Bregada.
The effect of lateral positions on gas exchange in patients with unilateral lung disease during mechanical ventilation.
Intensive Care Med, 7 (1981), pp. 231
[214]
DJ Gillespie, K Rehder.
Body position and ventilation-perfusion relationships in unilateral pulmonary disease.
Chest, 91 (1987), pp. 75-79
[215]
JL Vincent, Q Sun, MJ Dubois.
Clinical trials of immunomodulatory therapies in severe sepsis and septic shock.
Clin Infect Dis, 34 (2002), pp. 1084-1093
[216]
K Hubel, DC Dale, WC Liles.
Therapeutic use of cytokines to modulate phagocyte function for the treatment of infectious diseases: current status of granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, macrophage colony-stimulating factor, and interferon gamma.
J Infect Dis, 185 (2002), pp. 1490-1501
[217]
TJ Standiford, WC Tsai, B Mehrad, TA Moore.
Cytokines as targets of immunotherapy in bacterial pneumonia.
J Lab Clin Med, 135 (2000), pp. 129-138
[218]
GR Bernard, JL Vincent, PF Laterre, SP LaRosa, JF Dhainaut, A López-Rodríguez, et al.
Efficacy and safety of recombinant human activated protein C for severe sepsis.
N Engl J Med, 344 (2001), pp. 699-709
[219]
GA Joiner, D Salisbury, GE Bollin.
Utilizing quality assurance as a tool for reducing the risk of nosocomial ventilator-associated pneumonia.
Am J Med Qual, 11 (1996), pp. 100-103
[220]
SI Kelleghan, C Salemi, S Padilla, M McCord, G Mermilliod, T Canola, et al.
An effective continuous quality improvement approach to the prevention of ventilator-associated pneumonia.
Am J Infect Control, 21 (1993), pp. 322-330
[221]
RP Gaynes, S Solomon.
Improving hospital-acquired infection rates the CDC experience.
It Comm J Qual Improv, 22 (1996), pp. 457-467
[222]
R Gaynes, C Richards, J Edwards, TG Emori, T Horan, J Alonso Echanove, et al.
Feeding back surveillance data to prevent hospitalacquired infections.
Emerg Infect Dis, 7 (2001), pp. 295-298
[223]
RW Haley, DH Culver, JW White, WM Morgan, TG Emori, VP Munn, et al.
The efficacy of infection surveillance and control programs in preventing nosocomial infection in U.S. hospitals.
Am J Epidemiol, 121 (1985), pp. 182-205
[224]
A Josephson, Karanfil, H Alonso, A Watson, J Blight.
Risk-specific nosocomial infection rates.
Am J Med, 91 (1991), pp. 131-137
[225]
RK Amarvadi, JB Dimick, PJ Pronovost, PA Lipsett.
ICU nurse-to-patient ratio is associated with complications and resource use after esophagectomy.
Intensive Care Med, 26 (2000), pp. 1857-1862
[226]
JB Dimick, SM Swoboda, PJ Pronovost, PA Lipsett.
Effect of nurse to patient ratio in the intensive care unit on pulmonary complications and resource use after hepatectomy.
Am J Crit Care, 10 (2001), pp. 376-382
[227]
JM Nava, F Bella, J Garau, J Lite, MA Morera, C Martí, et al.
Predictive factors for invasive disease due to penicillin-resistant Streptococcus pneumoniae: a population based study.
Clin Infect Dis, 19 (1994), pp. 884-890
[228]
J Kaye, V Ashline, D Erickson, K Zeiler, D Gavigan, L Gannon, et al.
Critical care bug team: a multidisciplinary team approach to reducing ventilator-associated pneumonia.
Am J Infect Control, 28 (2000), pp. 197-201
[229]
M Kollef.
Avoidance of tracheal intubation as strategy to prevent ventilator associated pneumonia.
Intensive Care Med, 25 (1999), pp. 567-573
[230]
L Brochard, J Mancebo, M Wysocki, F Lofaso, G Conti, A Rauss, et al.
Noninvasive ventilation for acute exacerbation of chronic obstructive pulmonary disease.
N Engl J Med, 333 (1995), pp. 817-822
[231]
TJ Martin, JD Hovis, JP Constantino.
A randomized, prospective evaluation of non-invasive ventilation for acute respiratory failure.
Am J Respir Crit Care Med, 161 (2000), pp. 807-813
[232]
M Antonelli, G Conti, M Rocco, M Bufi, RA de Blasi, G Vivino, et al.
A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure.
N Engl J Med, 339 (1998), pp. 429-435
[233]
M Confalonieri, A Potena, G Carbone, R Della Porta, EA Tolley, GU Meduri.
Acute respiratory failure in patients with severe community-acquired pneumonia: a prospective randomized evaluation of noninvasive ventilation.
Am J Respir Crit Care Med, 160 (1999), pp. 1585-1591
[234]
S Díaz Lobato, MA Gómez Mendieta, S Mayoralas Alises.
Aplicaciones de la ventilación mecánica no invasiva en pacientes que reciben ventilación endotraqueal.
Arch Bronconeumol, 38 (2002), pp. 281-284
[235]
S Nava, N Ambrosino, E Clini, M Vitacca.
Non-invasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease: a randomised study.
Ann Intern Med, 128 (1998), pp. 721-728
[236]
M Ferrer, A Esquinas, F Arancibia, TT Bauer, G González, A Carrillo, et al.
Noninvasive ventilation during persistent weaning failure; a randomized controlled trial.
Am J Respir Crit Care Med, 168 (2003), pp. 70-76
[237]
G Hilbert, D Gruson, L Portel, JP Cardinaud.
Non-invasive pressure support ventilation in COPD patients with postextubation hypercapnic respiratory insufficiency.
Eur Respir J, 11 (1998), pp. 1349-1353
[238]
A Esteban, F Frutos-Vivar, ND Ferguson, Y Arabi, C Apezteguia, M González, et al.
Non-invasive positive-pressure ventilation not improves outcome of post-extubation respiratory failure: a randomized controlled trial.
N Engl J Med, 350 (2004), pp. 2452-2460
[239]
A Esteban, ND Ferguson, F Frutos-Vivar, Y Arabi, C Apezteguia, M González, et al.
Non-invasive positive pressure ventilation (NIPPV) does not prevent reintubation and may be harmful in patients with post-extubation respiratory distress: results of a randomizedcontrolled trial.
Am J Respir Crit Care Med, 167 (2003), pp. A301
[240]
SP Keenan, C Powers, DG McCormack, G Block.
Noninvasive positive-pressure ventilation for postextubation respiratory distress.
JAMA, 287 (2002), pp. 3238-3244
[241]
MS Niederman, LA Mandell, A Anzuelo, JB Bass, WA Broughton, GD Campbell, et al.
Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment, severity, antimicrobial therapy and prevention.
Am J Respir Crit Care Med, 163 (2001), pp. 1730-1754
[242]
JV Lightowler, JA Wedzicha, MW Elliott, FS Ram.
Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis.
BMJ, 326 (2003), pp. 185
[243]
EW Ely, AM Baker, DP Dunagan, HL Burke, AC Smith, PT Kelly, et al.
Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously.
N Engl J Med, 335 (1996), pp. 1864-1869
[244]
Task Force by the American College of Chest Physicians; American Association for Respiratory Care and the American College of Critical Care Medicine.
Evidence-based guidelines for weaning and discontinuing ventilatory support.
Chest, 120 (2001), pp. 375S-395S
[245]
LJ Gorman.
Cross infection in an intensive care unit by Klebsiella pneumoniae..
J Hosp Infect, 23 (1993), pp. 27-34
[246]
JS Garner, MS Faver.
CDC guidelines for hand-washing and hospital environment control.
Infect Control, 7 (1986), pp. 231-243
[247]
B Simmons, J Bryant, K Neiman.
The role of hand-washing in prevention of endemic intensive care unit infections.
Infect Control Hosp Epidemiol, 11 (1990), pp. 589-594
[248]
BN Doebbeling, GL Stanley, CT Sheetz.
Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units.
N Engl J Med, 327 (1992), pp. 88-93
[249]
H Kjolen, BM Andersen.
Hand-washing and disinfection of heavily contaminated hands: effective or ineffective?.
J Hosp Infect, 21 (1992), pp. 61-71
[250]
AI Harstein, MA Denny, VH Morthland.
Control of methicillinresistant Staphylococcus aureus in a hospital and an intensive care unit.
Infect Control Hosp Epidemiol, 16 (1995), pp. 405-411
[251]
F Álvarez, A Torres, F Rodríguez de Castro.
Recomendaciones para el diagnóstico de neumonía asociada a ventilador.
Med Intensiva, 25 (2001), pp. 271-282
[252]
BS Klein, WH Perloff, DG Maki.
Reduction of nosocomial infection during pediatric intensive care by protective isolation.
N Engl J Med, 320 (1989), pp. 1714-1721
[253]
A Torres, J Serra-Batllés, E Ros, C Piera.
Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position.
Ann Intern Med, 116 (1992), pp. 540-543
[254]
M Drakulovic, A Torres, T Bauer, J Nicolás, S Nogué, M Ferrer.
Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients.
Lancet, 354 (1999), pp. 1851-1858
[255]
A Dive, C Miesse, L Galanti, J Jamart, P Evrard, M González, et al.
Effect of erythromycin on gastric motility in mechanically ventilated critically ill patients: a double-blind, randomized, placebo-controlled study.
Crit Care Med, 23 (1995), pp. 1356-1362
[256]
RW McGallum, C Prakash, DM Campoli Richards, KL Goa.
Cisapride. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use as a prokinetic agent in gastrointestinal motility disorders.
Drugs, 36 (1988), pp. 652-681
[257]
J Thun, K Crossley, A Gerdts, M Maki, J Johnson.
Enteral hyperalimentation as a source of nosocomial infection.
Hosp Infect, 15 (1990), pp. 203-217
[258]
L Rocha Carvallo, B Morais, F Amaral, M Sigulem.
Hazard analysis and critical control point system approach in the evaluation of environmental and procedural source of contamination of enteral feeding in three hospitals.
JPEN, 24 (2000), pp. 296-303
[259]
L Mathus-Vliegen, J Binnekade, R de Haan.
Bacterial contamination of ready to use 1L feeding bottles and administration set in severely compromised intensive care patients.
Crit Care Med, 28 (2000), pp. 67-73
[260]
J Levy, Y van Laethem, G Verhaegen, C Perpete, J Butzler, R Wenzel.
Contaminated enteral nutrition solutions as a cause of nosocomial bloodstream infection: a study using plasmid fingerprinting.
JPEN, 13 (1989), pp. 228-234
[261]
D Dreyfuss, K Djedaini, P Weber, P Brun, JJ Lanore, J Rahmani, et al.
Prospective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change.
Am Rev Respir Dis, 143 (1991), pp. 738-743
[262]
EA Hess.
Weekly ventilator circuit changes. A strategy to reduce cost without affecting pneumonia rates.
Anesthesiology, 82 (1995), pp. 903
[263]
DE Craven, KA Steger, TW Barber.
Preventing nosocomial pneumonia: state of the art and perspectives for the 1990s.
Am J Med, 91 (1991), pp. 44S-53S
[264]
D Dreyfuss, K Djedaini, I Gros, L Mier, G le Bourdelles, Y Cohen, et al.
Mechanical ventilation with heated humidifiers or heat and moisture exchangers: effects on patient colonization and incidence of nosocomial pneumonia.
Am J Respir Crit Care Med, 151 (1995), pp. 986-992
[265]
MH Kollef, SD Shapiro, V Boyd, P Silver, B von Harz, E Trovillion, et al.
Randomized clinical trial comparing an extended-use hygroscopic condenser humidifier with heated water humidification in mechanically ventilated patients.
Chest, 113 (1998), pp. 759-767
[266]
SS Zeitoun, AL de Barros, S Diccini.
A prospective, randomized study of ventilator-associated pneumonia in patients using a closed vs. open suction system.
J Clin Nurs, 12 (2003), pp. 484-489
[267]
J Vallés, A Artigas, J Rello, N Bonsoms, D Fontanals, L Blanch, et al.
Continuous aspiration of subglottic secretions in preventing ventilator associated pneumonia.
Ann Intern Med, 122 (1995), pp. 179-186
[268]
MH Kollef, NJ Skubas, TM Sundt.
A randomized clinical trial of continuos aspiration of subglottic secretions in cardiac surgery patients.
Chest, 117 (1999), pp. 1339-1346
[269]
WA Rutala, DJ Weber, MF Gergen, AR Gratta.
Efficacy of a washerpasteurizer for disinfection of respiratory-care equipment.
Infect Control Hosp Epidemiol, 21 (2000), pp. 333-336
[270]
G Le Bourdelles, L Mier, B Fiquet, K Djedaini, G Saumon, F Coste, et al.
Comparison of the effects of heat and moisture exchangers and heated humidifiers on ventilation and gas exchange during weaning trials from mechanical ventilation.
Chest, 110 (1996), pp. 1294-1298
[271]
TJ Inglis, MR Millar, JG Jones, DA Robinson.
Tracheal tube biofilm as a source of bacterial colonization of the lung.
J Clin Microbiol, 27 (1989), pp. 2014-2018
[272]
Apezteguia C, Ríos F, Pezzola D. Tracheostomy: how, when and to whom? Review of the evidence in patients with respiratory failure under mechanical ventilation. Series: Update in Intensive Care and Emergency Medicine. Springer. In press 2005.
[273]
HR Collard, S Saint, MA Matthay.
Prevention of ventilator-associated pneumonia: an evidence-based systematic review.
Ann Intern Med, 138 (2003), pp. 494-501
[274]
AB Nathens, JC Marshall.
Selective decontamination of the digestive tract in surgical patients: a systematic review of the evidence.
Arch Surg, 134 (1999), pp. 170-176
[275]
DK Heyland, DJ Cook, R Jaeschke, L Griffith, HN Lee, GH Guyatt.
Selective decontamination of the digestive tract: an overview.
Chest, 105 (1994), pp. 1221-1229
[276]
M Kollef.
The role of selective digestive tract decontamination on mortality and respiratory tract infections: a meta-analysis.
Chest, 105 (1994), pp. 1101-1108
[277]
CMJE Vandenbroucke-Grauls, JP Vandenbroucke.
Effect of selective decontamination of the digestive tract on respiratory tract infections and mortality in intensive care units.
Lancet, 338 (1991), pp. 859-862
[278]
A Liberati, R D'Amico, S Pifferi, C Leonetti, V Torri, L Brazzi, et al.
Antibiotics for preventing respiratory tract infections in adults receiving intensive care.
Cochrane Database Syst Rev. 2000: CD000022. Review. Update in: Cochrane Database Syst Rev, (2000), pp. CD000022
[279]
R D'Amico, S Pifferi, C Leonetti, V Torri, A Tinazzi, A Liberatt.
Effectiveness of antibiotic prophylaxis in critically ill adult patients: a systematic review of randomised controlled trials.
BMJ, 316 (1998), pp. 1275-1279

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