Reducing ventilator-associated pneumonia in neonatal intensive care unit using “VAP prevention Bundle”: a cohort study

Azab, Seham F.; Sherbiny, Hanan S.; Saleh, Safaa Hamdy Ahmad; Elsaeed, Wafaa F; Elshafiey, Mona M.; Siam, Ahmed G.; Arafa, M.; Alghobashy, Ashgan Abdallah; Bendary, Eman A.; Basset, Maha A.A.; Ismail, Sanaa M.; Akeel, Nagwa E.; Elsamad, Nahla A.; Mokhtar, Wesam A.; Gheith, Tarek

doi:10.1186/s12879-015-1062-1

Cited by 89 publications

(128 citation statements)

References 33 publications

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“…Most of the interventions related to the care of the ventilation circuits and system maintenance without water condensation and exchange only in case of visible dirt or malfunction [9][10][11][12][13]15], followed the recommendations of IHI [23]. However, there are differences in the level of evidence of these strategies when applied in neonates because the evidence is considered weak.…”

Section: Brazil 2015mentioning

confidence: 99%

“…The practice of hand hygiene by the health professionals was described in most studies [8][9][10][11][12][13]15]. It is the most important and recognized measure for prevention and control of infections related to care.…”

Section: Brazil 2015mentioning

confidence: 99%

“…Among the interventions for maintenance of permeable airways, tracheal aspiration aseptically was identified with system closed and hands off use [9,10,13,14,16]. The use of the closed suction system has had low evidence in reducing PAV over the other technique of vacuum, with the system off [4,30].…”

Section: Brazil 2015mentioning

confidence: 99%

“…This generates a variety of interventions for oral hygiene in infants. In studies of the review, there was the use of saline 0.9%, sterile distilled water and breast milk [8,10,13].…”

Section: Brazil 2015mentioning

confidence: 99%

“…The intervention of the headboard elevation was present in most of the bundles [10][11][12][13][14][15], which is considered a weak evidence [25]. According to the CDC´s recommendation, there are differences in the angle of inclination for newborns and pediatric patients [27].…”

Section: Brazil 2015mentioning

confidence: 99%

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Bundle Method In Reducing Pneumonia Associated With Mechanical Ventilation In Newborns And Children: Integrative Review

França¹,

Cassiano

Vitorino

et al. 2016

Int Arch Med

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Infections related to health care are a public health problem, given the repercussions of the event to the morbidity and mortality of the population and having health spending. Pneumonia Associated to Mechanical Ventilation has the incidence of 8.1% to 57.1% in neonates and 23% in children. This study is an integrative literature review aimed to check the scientific production concerning the use of bundle guidelines to reduce of PAV in children and newborns in intensive care units and analyze the results of these research. For data collection, the keyword bundle, and the descriptors infant, newborn; Intensive Care Units, Neonatal Pneumonia, Ventilator-Associated and Child(ren) for online search in databases: PUBMED, SCOPUS, LILACS and CINHAL. The initial result of the search was 891 articles and after application of inclusion and exclusion criteria, the sample resulted in nine articles. This study points out that in general VAP prevention measures found in bundles were effective in reducing PAV rates in neonates and pediatric patients. However, there are still differences in the development of some interventions, especially for newborns. It is necessary to develop other studies, including the better level of evidence to address the use of bundle for PAV prevention of these population, considered more vulnerable to incidents related to health care.

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Section: Brazil 2015mentioning

confidence: 99%

Section: Brazil 2015mentioning

confidence: 99%

Section: Brazil 2015mentioning

confidence: 99%

“…This generates a variety of interventions for oral hygiene in infants. In studies of the review, there was the use of saline 0.9%, sterile distilled water and breast milk [8,10,13].…”

Section: Brazil 2015mentioning

confidence: 99%

Section: Brazil 2015mentioning

confidence: 99%

See 3 more Smart Citations

Bundle Method In Reducing Pneumonia Associated With Mechanical Ventilation In Newborns And Children: Integrative Review

França¹,

Cassiano

Vitorino

et al. 2016

Int Arch Med

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One Step Further Toward Defining the Optimal Respiratory Care Package for Neonates

Zivanovic

Roehr

2017

JAMA Pediatr

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Oropharyngeal Administration of Mother's Milk Prior to Gavage Feeding in Preterm Infants: A Pilot Randomized Control Trial

Abd-Elgawad

Eldegla

Khashaba

et al. 2019

J Parenter Enteral Nutr

126

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Background: Oropharyngeal administration of mother's colostrum in early days has an immunoprotective effect in preterm infants. Objectives: Our aim was to study the effect of oropharyngeal administration of mother's milk (OPAMM) on decreasing the incidence of nosocomial sepsis. Methods: In a pilot prospective randomized study on preterm (<32 weeks gestation and 1500 g weight) infants, we compared OPAMM practice (applying 0.2 mL of mother's colostrum or milk prior to gavage feeding until full oral feeding is reached) with regular gavage feeding. The primary outcome was incidence of culture-proven nosocomial sepsis. Secondary outcomes included bacterial colonization of the gastrointestinal tract, feeding intolerance, time to reach full feeding, incidence of necrotizing enterocolitis, ventilator-associated pneumonia, duration of respiratory support, incidence of bronchopulmonary dysplasia (BPD), length of hospital stay, and neonatal mortality. Results: The outcomes of 200 neonates (100 in each group) were analyzed. OPAMM practice did not significantly reduce the incidence of culture proven nosocomial sepsis (8% vs 13%, P = 0.35). Infants in the OPAMM group had a significantly lower growth of Klebsiella species in the oropharyngeal pouch, borderline lower incidence of ventilator-associated pneumonia, shorter duration of oxygen therapy, less episodes of feeding intolerance, reached full feeding earlier, and had a shorter length of hospital stay. OPAMM practice did not affect the incidence of necrotizing enterocolitis, BPD, or neonatal mortality. Conclusion: OPAMM prior to gavage feeding does not reduce the incidence of nosocomial sepsis but had beneficial effects on early achievement of feeding, and early hospital discharge in preterm very low-birth-weight infants. (JPEN J Parenter Enteral Nutr. 2020;44:92-104) Clinical Relevancy StatementGavage feeding in preterm infants deprives the oropharyngeal pouch from the beneficial effect of mother's colostrum and milk. Previous reports have shown immunoprotective and anti-inflammatory effects for mother's colostrum when given early to the oropharyngeal pouch. We found that oropharyngeal administration of mother's milk prior to gavage feeding was associated with shorter duration to achieve full feeding, duration of oxygen support, and length of hospital stay in preterm infants.From the

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Reducing ventilator-associated pneumonia in neonatal intensive care unit using “VAP prevention Bundle”: a cohort study

Cited by 89 publications

References 33 publications

Bundle Method In Reducing Pneumonia Associated With Mechanical Ventilation In Newborns And Children: Integrative Review

Bundle Method In Reducing Pneumonia Associated With Mechanical Ventilation In Newborns And Children: Integrative Review

One Step Further Toward Defining the Optimal Respiratory Care Package for Neonates

Oropharyngeal Administration of Mother's Milk Prior to Gavage Feeding in Preterm Infants: A Pilot Randomized Control Trial

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