Evidence on measures for the prevention of ventilator-associated pneumonia

Abstract

Ventilator-associated pneumonia (VAP) continues to be an important cause of morbidity and mortality in ventilated patients.Evidence-based guidelines have been issued since

Comparison of the endotracheal tube cuff pressure between a tapered- versus a cylindrical-shaped cuff after changing from the supine to the lateral flank position

“…1,3 In cases of short surgical procedures, the relatively high cuff pressure of the ETT also results in postoperative cuff-related complications, including sore throat, cough, and hoarseness. 2 In the present study, the average cuff pressure was 31 cm H 2 O, and 54% of patients who received tracheal intubation with the TaperGuard ETT showed a cuff pressure [ 30 cm H 2 O after the change to the lateral flank position.…”

“…[1][2][3] A cuff pressure of more than 30 cm H 2 O is known to cause obstruction to mucosal blood flow in the trachea. 4 Partial denuding of the basement membrane was found at an ETT cuff pressure over 50 cm H 2 O.…”

Patient to Nurse Ratio and Risk of Ventilator-Associated Pneumonia in Critically Ill Patients

“…Thus, our results underscore the value of a proactive extubation policy with a "sedation vacation" as recommended in current guidelines. 15 Further research is necessary to evaluate the relationship between higher staffing levels (patient to nurse ratio <2 to 1) and compliance rates with distinct evidence-based strategies to prevent VAP. In our study, the actual patient to nurse ratio should be taken into account (actual number of patients per nurse each day).…”

“…14 Enhancement of knowledge of evidence-based recommendations to prevent VAP and multifaceted implementation of care bundles focused on measures to prevent VAP may reduce the risk for this pneumonia. [15][16][17][18][19][20][21][22] Yet, because of the high workload and degree of urgency needed in ICUs, proper compliance with recommendations is difficult. Furthermore, the shortage of qualified ICU nurses is a common problem in many European countries.…”

Endotracheal tube cuff pressure management in adult critical care units in the National Hospital of Sri Lanka ; A baseline audit

“…Nevertheless, the use of a HVLP cuff does not guarantee an acceptable mucosal pressure unless the CP is maintained at 20-30cmH2O. 1 This prospective audit was designed to examine the CP management in ICUs of the National Hospital of Sri Lanka which is the largest teaching hospital in the region.…”