J Clin Outcomes Manage
Measures to prevent ventilator-associated pneumonia: which are efficacious?
Abad C, McKinley L, Safdar N
Abstract Objective: To review measures evaluated for efficacy in the prevention of ventilator-associated pneumonia (VAP). Methods: Review of the literature. Results: Prevention of VAP may successfully be undertaken using a number of tested strategies shown to be efficacious. These include education of health care providers, semirecumbent positioning of patients, use of intubation only when necessary, and avoidance of nasal intubation. Subglottic suctioning and topical chlorhexidine are promising approaches for VAP prevention. Routine use of small enteric or intermittent feedings, motility agents, acidification procedures, heat and moisture exchangers (rather than heated humidifiers) and frequent ventilator circuit changes are not currently supported by evidence for the prevention of VAP. There may be a link between blood transfusions and nosocomial pneumonia, and these should be avoided if possible. Conclusion: Prevention of VAP is possible through the use of several evidence-based strategies.
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