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What is new in the prevention of ventilator-associated pneumonia?

Stijn Blot UGent, Jordi Rello and Dirk Vogelaers UGent (2011) CURRENT OPINION IN PULMONARY MEDICINE. 17(3). p.155-159
abstract
Purpose of review: Ventilator-associated pneumonia (VAP) remains a frequent and severe complication in endotracheally intubated patients. Strict adherence to preventive measures reduces the risk of VAP. The objective of this paper is to review what has come forward in recent years in the nonpharmacological prevention of VAP. Recent findings: It seems advantageous to implement care bundles rather than single prevention measures. A solid basis of knowledge seems necessary to facilitate implementation and maintain a high adherence level. Continuous educational efforts have a beneficial effect on attitude toward VAP. Intermittent subglottic secretions drainage, continuous lateral rotation therapy, and polyurethane cuffed endotracheal tubes decrease the risk of pneumonia. In an in-vitro setting, an endotracheal tube with a taper-shaped cuff appears to better prevent fluid leakage compared to cylindrical polyurethane or polyvinylchloride cuffed tubes. Cuff pressure control by means of an automatic device and multimodality chest physiotherapy need further investigation, as do some aspects of oral hygiene. Summary: New devices and strategies have been developed to prevent VAP. Some of these are promising but need further study. In addition, more attention is being given to factors that might facilitate the implementation process and the challenge of achieving high adherence rates.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
ventilator-associated pneumonia, INTENSIVE-CARE UNITS, prevention, endotracheal tube, bundle, SUBGLOTTIC SECRETION DRAINAGE, EVIDENCE-BASED GUIDELINES, TUBE CUFF PRESSURE, NOSOCOMIAL INFECTION, ENDOTRACHEAL-TUBE, RANDOMIZED-TRIAL, KNOWLEDGE TEST, PROGRAM, NURSES
journal title
CURRENT OPINION IN PULMONARY MEDICINE
Curr. Opin. Pulm. Med.
editor
Alimuddin Zumla
volume
17
issue
3
issue title
Infectious diseases
pages
155 - 159
Web of Science type
Article
Web of Science id
000288740100005
JCR category
RESPIRATORY SYSTEM
JCR impact factor
3.075 (2011)
JCR rank
16/48 (2011)
JCR quartile
2 (2011)
ISSN
1070-5287
DOI
10.1097/MCP.0b013e328344db65
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1232996
handle
http://hdl.handle.net/1854/LU-1232996
date created
2011-05-24 12:00:46
date last changed
2012-06-01 00:30:34
@article{1232996,
  abstract     = {Purpose of review: Ventilator-associated pneumonia (VAP) remains a frequent and severe complication in endotracheally intubated patients. Strict adherence to preventive measures reduces the risk of VAP. The objective of this paper is to review what has come forward in recent years in the nonpharmacological prevention of VAP.
Recent findings: It seems advantageous to implement care bundles rather than single prevention measures. A solid basis of knowledge seems necessary to facilitate implementation and maintain a high adherence level. Continuous educational efforts have a beneficial effect on attitude toward VAP. Intermittent subglottic secretions drainage, continuous lateral rotation therapy, and polyurethane cuffed endotracheal tubes decrease the risk of pneumonia. In an in-vitro setting, an endotracheal tube with a taper-shaped cuff appears to better prevent fluid leakage compared to cylindrical polyurethane or polyvinylchloride cuffed tubes. Cuff pressure control by means of an automatic device and multimodality chest physiotherapy need further investigation, as do some aspects of oral hygiene.
Summary: New devices and strategies have been developed to prevent VAP. Some of these are promising but need further study. In addition, more attention is being given to factors that might facilitate the implementation process and the challenge of achieving high adherence rates.},
  author       = {Blot, Stijn and Rello, Jordi and Vogelaers, Dirk},
  editor       = {Zumla, Alimuddin},
  issn         = {1070-5287},
  journal      = {CURRENT OPINION IN PULMONARY MEDICINE},
  keyword      = {ventilator-associated pneumonia,INTENSIVE-CARE UNITS,prevention,endotracheal tube,bundle,SUBGLOTTIC SECRETION DRAINAGE,EVIDENCE-BASED GUIDELINES,TUBE CUFF PRESSURE,NOSOCOMIAL INFECTION,ENDOTRACHEAL-TUBE,RANDOMIZED-TRIAL,KNOWLEDGE TEST,PROGRAM,NURSES},
  language     = {eng},
  number       = {3},
  pages        = {155--159},
  title        = {What is new in the prevention of ventilator-associated pneumonia?},
  url          = {http://dx.doi.org/10.1097/MCP.0b013e328344db65},
  volume       = {17},
  year         = {2011},
}

Chicago
Blot, Stijn, Jordi Rello, and Dirk Vogelaers. 2011. “What Is New in the Prevention of Ventilator-associated Pneumonia?” Ed. Alimuddin Zumla. Current Opinion in Pulmonary Medicine 17 (3): 155–159.
APA
Blot, S., Rello, J., & Vogelaers, D. (2011). What is new in the prevention of ventilator-associated pneumonia? (A. Zumla, Ed.)CURRENT OPINION IN PULMONARY MEDICINE, 17(3), 155–159.
Vancouver
1.
Blot S, Rello J, Vogelaers D. What is new in the prevention of ventilator-associated pneumonia? Zumla A, editor. CURRENT OPINION IN PULMONARY MEDICINE. 2011;17(3):155–9.
MLA
Blot, Stijn, Jordi Rello, and Dirk Vogelaers. “What Is New in the Prevention of Ventilator-associated Pneumonia?” Ed. Alimuddin Zumla. CURRENT OPINION IN PULMONARY MEDICINE 17.3 (2011): 155–159. Print.