Prevention of ventilator-associated pneumonia

Prevention of ventilator-associated pneumonia

“…cefotaxime or ciprofloxacin) in the case of SDD. 54,62 de Smet et al have conducted the largest study concerning SOD and SDD to date, they confirmed a 2.9% decrease in the mortality rate with SOD, and a 3.5% decrease with SDD. Both decontamination procedures reduced the duration of MV, ICU and hospital length of stay, daily doses of antimicrobials and the incidence of ICU-acquired bacteremia caused by S. aureus, P. aeruginosa and Enterobacteriaceae.…”

“…28 Possibly the latter approach is the most sensible, because it is very difficult to predict the duration of MV. 54 There is no doubt that the use of this technique, continuously or intermittently, is effective in the prevention of VAP, 55---58 but to date none of the forms of aspiration have been highlighted as the best. Currently, both are implemented in order to prevent and reduce microaspiration and, for this purpose, specific ETT have been developed.…”

“…66 However, this study has a characteristic that has prevented the generalized recommendation of SOD and SDD: antibiotic resistance recorded in the studied ICU (Holland) is considered low (<5%) when compared to the rates of antibiotic resistance in other countries such as the USA. 54,65 Studies in different locations, with different rates of antibiotic resistance, are needed in order to obtain a better and more widespread perception of the long-term effect of these measures.…”

“…25,54,81 Most of the hospital teams that have evaluated preventive measures for VAP, have implemented the bundle developed by the Institute for Healthcare Improvement which is composed of: elevation of the head of the bed between 30…”

Evaluación del cumplimiento de un protocolo de prevención de Neumonía asociada a Ventilación mecánica en una UCI polivalente

“…4. Favorecer todos los procedimientos que permitan disminuir de forma segura la intubación y/o su duración, porque a mayor duración existe un mayor riesgo de NAVM (2,5,6,8,16,17). El Institute for Health Improvement (IHI) de Massachussetes ha identificado la interrupción diaria de la sedación y la valoración diaria del destete como una de las 4 intervenciones claves para disminuir la incidencia de NAVM (1) .…”