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<datestamp>2017-12-21</datestamp>
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<publisher>HAL CCSD</publisher>
<title lang=en>Effect of a fever control protocol-based strategy on ventilator-associated pneumonia in severely brain-injured patients.</title>
<creator>Launey, Yoann</creator>
<creator>Nesseler, Nicolas</creator>
<creator>Le Cousin, Audren</creator>
<creator>Feuillet, Fanny</creator>
<creator>Garlantezec, Ronan</creator>
<creator>Mallédant, Yannick</creator>
<creator>Seguin, Philippe</creator>
<contributor>Foie, métabolismes et cancer ; Université de Rennes 1 (UR1) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )</contributor>
<contributor>Service d'anesthésie réanimation chirurgicale ; Université de Rennes 1 (UR1) - Hôpital Pontchaillou</contributor>
<contributor>Biostatistique, Recherche Clinique et Mesures Subjectives en Santé ; Université de Nantes (UN)</contributor>
<contributor>Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )</contributor>
<description>International audience</description>
<source>ISSN: 1364-8535</source>
<source>EISSN: 1466-609X</source>
<source>Critical Care</source>
<publisher>BioMed Central</publisher>
<identifier>hal-01118640</identifier>
<identifier>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118640</identifier>
<source>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118640</source>
<source>Critical Care, BioMed Central, 2014, 18 (6), pp.689. 〈10.1186/s13054-014-0689-4〉</source>
<identifier>PUBMED : 25498970</identifier>
<relation>info:eu-repo/semantics/altIdentifier/pmid/25498970</relation>
<identifier>DOI : 10.1186/s13054-014-0689-4</identifier>
<relation>info:eu-repo/semantics/altIdentifier/doi/10.1186/s13054-014-0689-4</relation>
<identifier>PUBMEDCENTRAL : PMC4279880</identifier>
<language>en</language>
<subject>[SDV] Life Sciences [q-bio]</subject>
<type>info:eu-repo/semantics/article</type>
<type>Journal articles</type>
<description lang=en>IntroductionFever is associated with a poor outcome in severely brain-injured patients, and its control is one of the therapies used in this condition. But, fever suppression may promote infection, and severely brain-injured patients are frequently exposed to infectious diseases, particularly ventilator-associated pneumonia (VAP). Therefore, we designed a study to explore the role of a fever control protocol in VAP development during neuro-intensive care.MethodsAn observational study was performed on severely brain-injured patients hospitalized in a university ICU. The primary goal was to assess whether fever control was a risk factor for VAP in a prospective cohort in which a fever control protocol was applied and in a historical control group. Moreover, the density of VAP incidence was compared between the two groups. The statistical analysis was based on a competing risk model multivariate analysis.ResultsThe study included 189 brain-injured patients (intervention group, n¿=¿98, and historical control group, n¿=¿91). The use of a fever control protocol was an independent risk factor for VAP (hazard ratio 2.73, 95% confidence interval [1.38, 5.38; P¿=¿0.005]). There was a significant increase in the incidence of VAP in patients treated with a fever control protocol (26.1 versus 12.5 VAP cases per 1000 days of mechanical ventilation). In cases in which a fever control protocol was applied for >3 days, we observed a higher rate of VAP in comparison with the rate among patients treated for ¿3 days.ConclusionFever control in brain-injured patients was a major risk factor for VAP occurrence, particularly when applied for >3 days.</description>
<date>2014-12-15</date>
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