Ventilator-associated pneumonia prevention

According to the CDC, almost 1.7 million hospital-acquired infections (HAIs) occur yearly, contributing to approximately 99,000 deaths. Such infections were long accepted by clinicians as an inevitable hazard. Recent efforts demonstrate that simple measures can prevent the majority of common infections. Hospitals and providers must work to reduce the burden of these infections. Four specific infections account for more than 80 percent of all hospital-related infections. They are surgical site infections, catheter-associated urinary tract infections, central venous catheter-related bloodstream infections, and ventilator-associated pneumonia. Preventing the transmission of antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) remains an important infection control priority. Effective measures exist to prevent the most common healthcare-related infections. 

Prevention of Hospital-Acquired and Ventilator-Associated Pneumonia... 

Kollef MH. Prevention of hospital-associated pneumonia and ventilator-associated pneumonia. Crit Care Med 2004 32 1396-1405. 

Prevent Ventilator-Associated Pneumonia... by implementing a series of interdependent, scientifically grounded steps... 

Selective decontamination of the gastrointestinal tract was conceptualised with a view to preventing nosocomial infection (mainly due to enterobacteriaciae), specifically ventilator-associated pneumonia, in intensive care units. Protocols typically included the prescription of an intravenous cephalosporin with good activity against such Gram-negative pathogens (e.g. cefotaxime) with co-prescribed, poorly... 

Young PJ, Ridley SA. Ventilator-associated pneumonia Diagnosis and prevention. Anaesthesia 1999 54 1183-1197. 

Kollef MH. The prevention of ventilator-associated pneumonia. N Engl J Med 1999 340 627-634. 

Continuous aspiration of subglottic secretions to prevent ventilator-associated pneumonia ... 

Esmail, R., Duchscherer, G., Giesbrecht, J., King, J., Ritchie, P., Zuege, D., Prevention of Ventilator-Associated Pneumonia in the Calgary Health Region A Canadian Success Story, Healthcare Quarterly, Vol. 11, No. 3, 2008, pp. 129-136. 

Ventilation-associated pneumonia continues to be a common and costly complication of critical care [13 ]. It develops after aspiration of bacteria from the oropharynx into the lung and subsequent failure of host defences to clear the bacteria. Dental plaque biofilms are colonized by respiratory pathogens in ventilated patients. Thus, improvements in oral hygiene in these patients may prevent pneumonia. In a randomized study of the minimum frequency of apphcation of chlorhexidine gluconate necessary to reduce oral colonization by pathogens in 175 intubated patients, decontamination of the oral cavity did not reduce the total amount of potential respiratory pathogens. However the chlorhexidine oral rinse did reduce the number of Staphylococcus aureus organisms in the dental... 

Collard HR, Saint S, Matthay M, et al. Prevention of ventilator-associated pneumonia an evidence-based systematic review. Ann Intern Med 2003 138 494—501. 

Dodek P, Keenan S, Cook D, et al. Evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia. Ann Intern Med 2004 141 305-313. 

Valles J, Artigas A, Rello J, et al. Continuous aspiration of subglottic secretions in preventing ventilator-associated pneumonia. Ann Intern Med 1995 122 179-186. 

Kelleghan SI, Salemi C, Padilla S, McCord M, Mermilliod G, Canola T, Becker L. An effective continuous quality improvement approach to the prevention of ventilator-associated pneumonia. Am J Infect Control 1993 21(6) 322-330. 

Table 4 Ventilator-Associated Risk Factors and Preventive Measures for Nosocomial Pneumonia...

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