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Background: In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign. Methods: On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients. For each of these, data about the application of the bundle and the possible treatment for VAP were recorded. Results: Between 36.6 and 54.8% of the 120 Belgian ICUs participated in the successive surveys. While the characteristics of ventilated patients remained similar throughout the years, the percentage of ventilated patients and especially the duration of ventilation significantly decreased before and after the national VAP bundle campaign. Ventilator care also profoundly changed: Controlling cuff pressure, head positioning above 30 degrees were obtained in more than 90% of cases. Oral care was more frequently performed within a day, using more concentrated solutions of chlorhexidine. Subglottic suctioning also was used but in only 24.7% of the cases in the last years. Regarding the prevalence of VAP, it significantly decreased from 28% of ventilated patients in 2010 to 10.1% in 2016 (p <= 0.0001). Conclusion: Although a causal relationship cannot be inferred from these data, the successive surveys revealed a potential impact of the VAP bundle campaign on both the respiratory care of ventilated patients and the prevalence of VAP in Belgian ICUs encouraging them to follow the guidelines.
Keywords
VAP, VAP bundle, Belgian ICUs, VAP survey, VENTILATOR-ASSOCIATED PNEUMONIA, PREVENTION, PROGRAM, DECONTAMINATION, QUALITY, TRIAL, ICU

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Please use this url to cite or link to this publication:

Chicago
Jadot, Laurent, Luc Huyghens, Annik de Jaeger, Marc Bourgeois, Dominique Biarent, Adeline Higuet, Koen de Decker, et al. 2018. “Impact of a VAP Bundle in Belgian Intensive Care Units.” Annals of Intensive Care 8.
APA
Jadot, L., Huyghens, L., de Jaeger, A., Bourgeois, M., Biarent, D., Higuet, A., de Decker, K., et al. (2018). Impact of a VAP bundle in Belgian intensive care units. ANNALS OF INTENSIVE CARE, 8.
Vancouver
1.
Jadot L, Huyghens L, de Jaeger A, Bourgeois M, Biarent D, Higuet A, et al. Impact of a VAP bundle in Belgian intensive care units. ANNALS OF INTENSIVE CARE. 2018;8.
MLA
Jadot, Laurent, Luc Huyghens, Annik de Jaeger, et al. “Impact of a VAP Bundle in Belgian Intensive Care Units.” ANNALS OF INTENSIVE CARE 8 (2018): n. pag. Print.
@article{8585824,
  abstract     = {Background: In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign. 
Methods: On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients. For each of these, data about the application of the bundle and the possible treatment for VAP were recorded. 
Results: Between 36.6 and 54.8\% of the 120 Belgian ICUs participated in the successive surveys. While the characteristics of ventilated patients remained similar throughout the years, the percentage of ventilated patients and especially the duration of ventilation significantly decreased before and after the national VAP bundle campaign. Ventilator care also profoundly changed: Controlling cuff pressure, head positioning above 30 degrees were obtained in more than 90\% of cases. Oral care was more frequently performed within a day, using more concentrated solutions of chlorhexidine. Subglottic suctioning also was used but in only 24.7\% of the cases in the last years. Regarding the prevalence of VAP, it significantly decreased from 28\% of ventilated patients in 2010 to 10.1\% in 2016 (p {\textlangle}= 0.0001). 
Conclusion: Although a causal relationship cannot be inferred from these data, the successive surveys revealed a potential impact of the VAP bundle campaign on both the respiratory care of ventilated patients and the prevalence of VAP in Belgian ICUs encouraging them to follow the guidelines.},
  articleno    = {65},
  author       = {Jadot, Laurent and Huyghens, Luc and de Jaeger, Annik and Bourgeois, Marc and Biarent, Dominique and Higuet, Adeline and de Decker, Koen and Vander Laenen, Margot and Oosterlynck, Baudewijn and Ferdinande, Patrick and Reper, Pascal and Brimioulle, Serge and Van Cromphaut, Sophie and De Clety, St{\'e}phane Clement and Sottiaux, Thierry and Damas, Pierre},
  issn         = {2110-5820},
  journal      = {ANNALS OF INTENSIVE CARE},
  language     = {eng},
  pages        = {7},
  title        = {Impact of a VAP bundle in Belgian intensive care units},
  url          = {http://dx.doi.org/10.1186/s13613-018-0412-8},
  volume       = {8},
  year         = {2018},
}

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