Ventilator-associated events: prevalence and mortality in Japan

In 2013, the Centers for Disease Control and Prevention (CDC)/the National Healthcare Safety Network (NHSN) issued new surveillance algorithms for ventilator-associated events (VAEs) (1). VAEs are comprehensive respiratory complications that occur in conjunction with use of mechanical ventilation (MV). The VAE definition was developed as a new indicator of quality of care in intensive care unit (ICU) to replace previously used ventilator-associated pneumonia (VAP) (2-4). Its advantages are all objective, simple, and potentially automatable. CDC/NHSN has placed emphasis on shifting surveillance away from traditional VAP to VAEs to eliminate subjectivity in surveillance (5-8). Because of promulgation of VAEs, a number of studies have been conducted in the United States and other Western countries (9-14) to evaluate its practicality as a quality indicator (QI) in ICU. The recent reports demonstrated that VAEs were associated with prolonged use of MV (11,15,16) prolonged ICU stay (2,12,17) and increased mortality (15,18,19)