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Infectious Diseases


Answer 4
  1. Optimization of endotracheal tube cuff pressures. Ventilator-associated pneumonia generally results from bacterial colonization of the airways and digestive tract and aspiration of upper airway secretions. Several strategies have been recommended to prevent ventilator-associated pneumonia.4 Effective interventions include implementation of strict infection control measures, removal of nasogastric and endotracheal tubes as soon as possible, semirecumbent positioning, oral intubation, avoidance of gastric distension, drainage of condensate from ventilator circuits, and maintenance of adequate endotracheal tube cuff pressures to avoid aspiration around the cuff. Strategies believed to be ineffective include routine changes of the ventilator circuits, use of disposable suction catheters, and chest physiotherapy. Moreover, selective digestive antimicrobial decontamination may contribute to the emergence of antibiotic resistance.

    REFERENCE
    4.
     Kollef M. The prevention of ventilator-associated pneumonia. N Engl J Med 1999;340:627-34.

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