Ventilator Associated Pneumonia

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APInterventions and Practices Considered
1. General prophylaxis
2. Measures to achieve safe mechanical ventilation
3. Measures to prevent aspiration
4. Selective use of antibiotics to control outbreaks 
Note: Routine use of oral and systemic antibiotics was considered but not recommended. 5. Oral care with antiseptic agents
6. Daily interruptions or lightening of sedation and avoidance of paralytic agents 7. Gastrointestinal bleeding prophylaxis with either H2 antagonists or sucralfate 8. Transfusion of red blood cell and other allogeneic blood products in selected patients 9. Insulin therapy if indicated

Major Outcomes Considered
* Length of stay in intensive care unit (ICU)
* Morbidity and mortality
Incidence of healthcare-associated infections

Interventions and Practices Considered
1. Elevation of the head of the bed
2. Maintaining cuff pressure in the endotracheal tube between 20-25 mmHg 3. Circuit changes
4. Use of heated humidifiers and heat and moisture exchangers 5. Providing oral care with chlorhexidine and water-soluble mouth moisturizer 6. Secretion removal with specially designed endotracheal tubes 7. Closed, in-line suctioning (no recommendation made)

8. Evaluation for kinetic bed therapy
9. Sedation reduction
10. Assessment of weaning readiness with brief weaning trials 11. Stress ulcer disease prophylaxis
12. Deep vein thrombosis prophylaxis

Ventilator-associated Pneumonia (VAP)
Ventilator-associated pneumonia is a lung infection that develops in a person who is on a ventilator. A ventilator is a machine that is used to help a patient breathe by giving oxygen through a tube placed in a patient’s mouth or nose, or through a hole in the front of the neck. An infection may occur if germs enter through the tube and get into the...
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