Ventilator-associated pneumonia and its prevention

@article{Bouadma2012VentilatorassociatedPA,
  title={Ventilator-associated pneumonia and its prevention},
  author={Lila Bouadma and Michel Wolff and Jean-Christophe Lucet},
  journal={Current Opinion in Infectious Diseases},
  year={2012},
  volume={25},
  pages={395–404}
}
Purpose of review Given that ventilator-associated pneumonia (VAP) causes substantial morbidity, mortality and costs, prevention of this infectious process is a major challenge. Recent findings This study provides an update on the prevention of VAP, focusing on the ability of preventive measures to improve patient outcomes and concentrating wherever possible on the data published within the past 5 years. Particular attention is being paid to the latest approach to facilitate the implementation… 
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116 Citations
Highly Influential Citations
5
Background Citations
28
Methods Citations
4
Results Citations
1

116 Citations

Citation Type

Citation Type

The Most Recent Strategies for VAP (Ventilator-Associated Pneumonia) Prevention
TLDR
Although some preventive strategies need to be validated in the context of clinical trials, implementation of preventive measures grouped into bundles can improve their efficacy.
Update on ventilator-associated pneumonia
TLDR
The concept of infection-related ventilator-associated complication has been proposed as a surrogate of VAP to be used as a benchmark indicator of quality of care and bundles of prevention measures are effective in decreasing the VAP rate.
Ventilator-associated pneumonia: present understanding and ongoing debates
TLDR
The morbidity and mortality related to VAP remain high and, in the absence of a gold standard test for diagnosis, suspected VAP patients should be started on antibiotics based on recommendations per the 2005 ATS guidelines and knowledge of local antibiotic susceptibility patterns.
Prevention and Management of Ventilator-Associated Pneumonia
TLDR
This comprehensive review explores the current understanding of the etiology and pathogenesis of VAP and proposes a strategy for its treatment and prevention.
Ventilator-Associated Pneumonia: Nursing Implications
TLDR
Preventive measures focus on adaptive risk factors, mediated by strategies based on non-pharmacological and pharmacological evidence-based strategies recommended by guidelines to reduce the risks associated with endotracheal intubation and prevent the micro aspiration from pathogens to the lower airways.
Prevention of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia
TLDR
Hospital-acquired pneumonia (HAP) is the most frequent hospital infection after urinary tract infection, while it is at the first place in ICU, and VAP bundle of care can be a useful tool set for prevention.
Hospital-acquired pneumonia and ventilator-associated pneumonia: recent advances in epidemiology and management
TLDR
HAP/VAP is a major cause of deaths, morbidity and resources utilization, notably in patients with severe underlying conditions, and the development of new diagnostic tools and therapeutic weapons is urgently needed to face the epidemic of multidrug-resistant pathogens.
Association of compliance of ventilator bundle with incidence of ventilator-associated pneumonia and ventilator utilization among critical patients over 4 years
TLDR
Replicating the current finding in multicenter randomized trials is required before establishing any causal link between IHI ventilator bundle implementation and VAP rates among adult critical patients in a tertiary care center in Saudi Arabia.
Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update
TLDR
This expert guidance document is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America, the American Hospital Association, the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.
Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update
TLDR
This expert guidance document is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.
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References

SHOWING 1-10 OF 75 REFERENCES
Preventing ventilator-associated pneumonia: could silver-coated endotracheal tubes be the answer?
TLDR
Preliminary data obtained in animal models and from small randomized human studies support the hypothesis that an endotracheal tube coated externally and internally with a potent antiseptic product such as silver could exert a sustained antimicrobial effect within the proximal airways and block biofilm formation at its surface.
The paradox of ventilator-associated pneumonia prevention measures
TLDR
The paradox makes changes in VAP rates alone an unreliable measure of whether VAP prevention measures are truly beneficial to patients and behooves us to measure their impact on patient outcomes before advocating their adoption.
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TLDR
Use of noninvasive techniques for diagnosis, new methods and strategies for prevention, and, finally, the efficacy of monotherapy and de-escalation in the treatment of VAP are discussed.
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  • Medicine
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TLDR
There is a growing impetus to eliminate ventilator-associated pneumonia (VAP) in the United States and many hospitals have adopted bundled sets of prevention measures to try to drive down their VAP rates.
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TLDR
Some ventilator circuit and secretion management strategies may influence VAP rates in critically ill patients, and whether these strategies are adopted in practice depends on several factors such as the magnitude and precision of estimates of benefit and harm, as well as access, availability, and costs.
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TLDR
This study examined factors associated with ventilator-associated pneumonia and explored baseline and time-dependent characteristics, including measures of illness severity, factors relating to mechanical ventilation, variables in the gastropulmonary route of infection, and drug exposure.
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TLDR
In this small trial, chest physiotherapy in ventilated patients was independently associated with a reduction in VAP, suggesting benefit in prevention of VAP requires confirmation with a larger randomised controlled trial.
Reduction of ventilator-associated pneumonia: active versus passive guideline implementation
TLDR
An active implementation programme increased staff compliance with evidence-based interventions and was associated with a significant reduction in VAP acquisition.
Clinical and economic consequences of ventilator-associated pneumonia: A systematic review
TLDR
Ventilator-associated pneumonia occurs in a considerable proportion of patients undergoing mechanical ventilation and is associated with substantial morbidity, a two-fold mortality rate, and excess cost, and strategies that effectively prevent VAP are urgently needed.
Does this patient have ventilator-associated pneumonia?
TLDR
Routine bedside evaluation coupled with radiographic information provides suggestive but not definitive evidence that VAP is present or absent, and clinicians should be ready to consider additional tests that provide further evidence for VAP or that establish another diagnosis.
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