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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: prevention
John Muscedere1, Peter Dodek, Sean Keenan
1Department of Medicine, Queen's University, Kingston, Canada K7L 2V7.
Journal of Critical Care
|March 25, 2008
Summary
Implementing evidence-based strategies can reduce ventilator-associated pneumonia (VAP). Recommendations include specific intubation routes, circuit management, and patient positioning for VAP prevention.
Area of Science:
- Critical Care Medicine
- Infectious Disease Prevention
- Respiratory Therapy
Background:
- Ventilator-associated pneumonia (VAP) is a significant contributor to morbidity and mortality in critically ill patients requiring mechanical ventilation.
- Effective prevention strategies are crucial for improving patient outcomes and reducing healthcare-associated infections.
Purpose of the Study:
- To establish evidence-based guidelines for the prevention of ventilator-associated pneumonia (VAP).
- To synthesize current research to inform clinical practice in VAP prevention.
Main Methods:
- Systematic literature search of randomized controlled trials and systematic reviews from 1980 to October 2006.
- Databases searched include MEDLINE, EMBASE, CINAHL, and Cochrane Library.
- Panel assessed internal validity, effect size, and clinical consensus for safety, feasibility, and economics.
Main Results:
- Recommendations for VAP prevention include orotracheal intubation, single-use ventilator circuits, timely circuit changes only if soiled, regular heat and moisture exchanger changes, closed suction systems, subglottic secretion drainage, and head-of-bed elevation to 45 degrees.
- Consideration for rotating beds and oral antiseptic rinses is suggested.
- Bacterial filters and iseganan are not recommended; no recommendations made for sinusitis screening, humidification type, tracheostomy timing, prone positioning, or specific antibiotic strategies.
Conclusions:
- A substantial body of evidence supports various strategies for VAP prevention.
- Application of these evidence-based guidelines can potentially decrease the incidence of VAP, a serious nosocomial infection.
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