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What is new in the prevention of ventilator-associated pneumonia?
MedLine Citation:
PMID:  21326100     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Stijn Blot; Jordi Rello; Dirk Vogelaers
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-14
Journal Detail:
Title:  Current opinion in pulmonary medicine     Volume:  -     ISSN:  1531-6971     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503765     Medline TA:  Curr Opin Pulm Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aGeneral Internal Medicine & Infectious Diseases, Ghent University Hospital, Ghent, Belgium bHospital Universitari Vall d'Hebron, Vall D'Hebron Institute of Research, CIBERES, Universitat Autonoma de Barcelona, Barcelona, Spain.
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