ABSTRACT
Nosocomial pneumonias related to mechanical ventilation in patients admitted to intensive care units occur in 25-33% of all hospitalized patients. They are responsible for a growing number of deaths in the ICU and represent enormous costs annually. Although they form only 5-15% of hospitalized beds, ICUs account for 10-25% of health care costs internationally. A large amount of this cost goes in treatment and care of patients with ventilator-associated pneumonia [VAT's]. We undertook a prospective observational study in our intensive care unit where a simple bacterial filter was used in the ventilator circuit of each patient and changed daily. The incidence of VAPs occurring over a period of three months [prior and after the intervention] was observed. This study was carried out in our twelve-bedded multidisciplinary ICU in an urban tertiary care hospital. This is an urban referral center where the incidence of VAPs in the quarter prior to the intervention, Oct-Dec 2002, was 13.6 per 1000 patients. Positive VAP was diagnosed based on results of tracheal secretions correlated with clinical findings. A light weight filter [HME] was used in the ventilator circuit and changed on a daily basis. The incidence of VAP dropped to 2/1000 patients in the next quarter, Jan-Mar 2003. Ventilator associated pneumonias contribute to a great deal of the morbidity, cost and mortality as well as duration of stay in ICU patients. The introduction of bacterial filters [at the minimal cost of Rs. 100 or $1.6 daily] has significantly reduced this incidence, thereby pointing towards a positive trend at a minimal cost. This promising intervention should be tested in a larger cohort of patients