Prevention of ventilator-associated pneumonia by selective decontamination of the digestive tract

Silvestri, Luciano; Saene, H. K. F. van; Cal, Miguel A. de la; Sarginson, R. E.; Thomann, Corrado

doi:10.1183/09031936.00023808

Cited by 6 publications

(2 citation statements)

References 23 publications

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“…[9][10][11][12][13][14][15] The most important measures are continuous medical education, [16][17][18] continuous suctioning of subglottic secre-tions, 19 semi-recumbent position, 11,[20][21][22][23][24][25] oral hygiene with chlorhexidine, 26 and selective digestive decontamination. 6,[27][28][29][30][31] Knowledge of guidelines for prevention of VAP among healthcare workers (HCWs) has been infrequently assessed and mainly in staff nurses only. The gaps between individual knowledge of VAP prevention and actual daily clinical practice have not been compared.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Ventilator-Associated Pneumonia: Can Knowledge and Clinical Practice Be Simply Assessed in a Large Institution?

Pérez‐Granda

Muñóz

Heras³

et al. 2012

Respir Care

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OBJECTIVE: User-friendly scores to assess knowledge of guidelines for prevention of ventilatorassociated pneumonia (VAP) are scarce and have mainly evaluated nurses, but not students or physicians. Gaps between knowledge and actual clinical practice have not been sufficiently analyzed. We assessed knowledge of and adherence to guidelines for prevention of VAP among physicians, nurses, and students in adult ICUs. METHODS: All adult ICU healthcare workers were invited to complete a 20-point questionnaire. The first part assessed personal knowledge of international guidelines for prevention of VAP; the second part assessed daily clinical practice. Personal knowledge and daily practice were scored from 0 to 10 points. RESULTS: We invited 257 ICU healthcare workers to participate in the study, and 167 (65%) accepted (32/54 physicians, 108/176 nurses, and 27/27 students). The median (IQR) personal knowledge scores for physicians, nurses, and students were 6 (5-7), 5 (4 -6), and 5 (4 -7), respectively. The median scores for daily clinical practice for physicians and nurses were 5 (4 -6) and 4 (3-5), respectively. Healthcare workers with more than 1 year of ICU experience scored significantly better in personal knowledge than those with less experience: 6 (5-7) versus 4 (3-6), P ‫؍‬ .004. CONCLUSIONS: A simple, easy-to-complete questionnaire enabled us to rapidly evaluate personal knowledge and reported clinical practice in prevention of VAP in large teaching institutions. These scores will be used as baseline figures to assess the impact of educational and intervention campaigns.

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Section: Introductionmentioning

confidence: 99%

Prevention of Ventilator-Associated Pneumonia: Can Knowledge and Clinical Practice Be Simply Assessed in a Large Institution?

Pérez‐Granda

Muñóz

Heras³

et al. 2012

Respir Care

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“…These antibiotics were given either via nasogastric tube or intravenously for up to 4 days. Although these studies showed selective digestive decontamination to be effective at reducing pneumonia [35,36], administering prophylactic antibiotics to all mechanically ventilated patients in the ICU would foster the development of multidrug-resistant organisms [37,38] and is therefore discouraged.…”

Section: Selective Digestive Decontaminationmentioning

confidence: 99%

Pneumonia in Trauma Patients

Schellenberg

Inaba

2017

Curr Trauma Rep

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Purpose of Review This article reviews the new definitions of pneumonia, discusses risk factors for pneumonia among trauma patients, presents the latest evidence for prevention strategies, discusses the best ways to make the diagnosis, and reviews the microbiology and treatment for trauma patients with pneumonia. Recent Findings Pneumonia can be prevented by decreasing the duration of mechanical ventilation using daily paired spontaneous awakening and breathing trials, but not with early tracheostomy placement. Other useful prevention strategies include semirecumbent positioning and oral care. Mini-BAL is a sensitive and specific means of securing the diagnosis of pneumonia that does not require a physician to be present and is therefore especially useful in busy trauma centers. Summary Pneumonia is a frequent complication among trauma patients. Risk factors are largely unmodifiable. However, trauma centers can institute routine daily paired spontaneous awakening and breathing trials to decrease the duration of ventilation and incidence of pneumonia. Future research is needed to further characterize the microbiology of pneumonia among trauma patients. Keywords Pneumonia. Pneumonia in trauma. Infection in trauma. Surgical critical care This article is part of the Topical Collection on Infection and Trauma

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The Pros, Cons, and Unknowns of Search and Destroy for Carbapenem-Resistant Enterobacteriaceae

Moodley

Whitelaw

2015

Curr Infect Dis Rep

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Antibiotic drug discovery has not kept pace with the development of microbial resistance to these agents. There are ever increasing reports where the causative agents of serious infections are multi-drug resistant and in some cases resistant to all known antibiotics. The emergence and spread of carbapenemase-producing Enterobacteriaceae has heightened awareness regarding antibiotic stewardship programs and infection prevention and control measures. There has been much controversy regarding the utility of the "search and destroy" strategy to prevent the spread of carbapenem-resistant Enterobacteriaceae. These controversies center on screening and management of carriers, including decontamination and isolation. It is however clear that a functional infection prevention and control program is fundamental to any strategy that serves to address the spread of microbes within a healthcare facility.

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Prevention of ventilator-associated pneumonia by selective decontamination of the digestive tract

Cited by 6 publications

References 23 publications

Prevention of Ventilator-Associated Pneumonia: Can Knowledge and Clinical Practice Be Simply Assessed in a Large Institution?

Prevention of Ventilator-Associated Pneumonia: Can Knowledge and Clinical Practice Be Simply Assessed in a Large Institution?

Pneumonia in Trauma Patients

The Pros, Cons, and Unknowns of Search and Destroy for Carbapenem-Resistant Enterobacteriaceae

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