1999
DOI: 10.1046/j.1365-2044.1999.01035.x
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Ventilator‐associated pneumoniaDiagnosis, pathogenesis and prevention

Abstract: SummaryVentilator-associated pneumonia is common, difficult to diagnose, affects the most vulnerable of patients and carries a high mortality. During prolonged mechanical ventilation the oropharynx, sinuses, dentition and stomach of critically ill patients become colonised with pathogenic bacteria. Colonised secretions pool in the oropharynx and subglottic space. These secretions repeatedly gain access to the lower airways by leakage past the tracheal tube cuff. If host defence mechanisms are overwhelmed, mult… Show more

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Cited by 40 publications
(26 citation statements)
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“…In our study, we considered 60 to 70 cmH 2 O for LMA and 20-30 cmH 2 O for ETT cuffs to be normal. As soon as an airway was established, cuff pressures were measured and recorded in this study.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…In our study, we considered 60 to 70 cmH 2 O for LMA and 20-30 cmH 2 O for ETT cuffs to be normal. As soon as an airway was established, cuff pressures were measured and recorded in this study.…”
Section: Discussionmentioning
confidence: 99%
“…Cuffs inflated to an inappropriately high pressure cause ischemia by reducing tracheal mucosal blood flow, while cuffs inflated at pressures lower than necessary give rise to inadequate ventilation or aspiration of gastric contents (1). In critically ill patients, contaminated secretions can leak through the tracheal cuff and result in ventilator-associated pneumonia (2,3). High cuff pressure increases the risk for tracheomalacia and tracheal dilation in patients intubated for a long time (4).…”
mentioning
confidence: 99%
“…12 Though enteral feed via nasogastric tube has been stated as a risk factor due to increased gastric pH, volume and regurgitation, it may have improved the nutritional status, decreased gut translocation and prevented VAP in our patients. 14,15 Intermittent feed, semi-recombinant position at 45°, avoidance of gastric over distension and use of prokinetics when required, has decreased the incidence of VAP in some studies. 16,17 Similar finding was observed in our study.…”
Section: Discussionmentioning
confidence: 99%
“…• Gastrostasis, reflux and aspiration are promoted by a static supine position.Ventilator-associated pneumonia, and prolonged ventilation and intensive care stay are consequences [54], increasing morbidity, mortality and costs [55,56]. Among elderly patients with cervical spine injuries, 26.8% died during treatment, principally as a result of respiratory complications [57].…”
mentioning
confidence: 99%