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01-04-2012 | Editorial

Preventing ventilator-associated pneumonia: is it ultimately only a matter of gravity?

Author: Ioannis Pneumatikos

Published in: Intensive Care Medicine | Issue 4/2012

Excerpt

Ventilator-associated pneumonia (VAP) is defined as pneumonia that develops 48 h or longer after initiation of mechanical ventilation via an endotracheal tube (ET). The incidence of VAP is high, ranging from 10 to 30%. VAP is associated with significantly increased morbidity and mortality, hospital length of stay, and costs [1]. Prevention of VAP is therefore one of the foremost aims in mechanically ventilated critically ill patients. …

Safdar N, Dezfulian C, Collard HR, Saint S (2005) Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med 33:2184–2193PubMedCrossRef

Kollef MH (1999) The prevention of ventilator associated pneumonia. N Engl J Med 340(8):627–634PubMedCrossRef

Bonten MJ, Gaillard CA, de Leeuw PW, Stobberingh EE (1997) Role of colonization of the upper intestinal tract in the pathogenesis of ventilator associated pneumonia. Clin Infect Dis 24(3):309–319PubMedCrossRef

Torres A, Serra-Batlles J, Ros E, Piera C, Puig de la Bellacasa J, Cobos A, Lomena F, Rodriguez-Roisin R (1992) Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position. Ann Intern Med 116:540–543PubMed

American Thoracic Society, Infectious Diseases Society of America (2005) Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumoni. Am J Respir Crit Care Med 171:388–416CrossRef

Hawe CS, Ellis KS, Cairns CJ, Longmate A (2009) Reduction of ventilator-associated pneumonia active versus passive guideline implementation. Intensive Care Med 35:1180–1186PubMedCrossRef

Drakulovic MB, Torres A, Bauer TT, Nicolas JM, Nogue S, Ferrer M (1999) Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised trial. Lancet 354:1851–1858PubMedCrossRef

Keeley L (2007) Reducing the risk of ventilator-acquired pneumonia through head of bed elevation. Nurs Crit Care 12:287–294PubMedCrossRef

van Nieuwenhoven CA, Vandenbroucke-Grauls C, van Tiel FH, Joore HC, van Schijndel RJ, van der Tweel I, Ramsay G, Bonten MJ (2006) Feasibility and effects of the semirecumbent position to prevent ventilator-associated pneumonia: a randomized study. Crit Care Med 34:396–402PubMedCrossRef

10.

Combes A (2006) Backrest elevation for the prevention of ventilator-associated pneumonia: back to the real world? Crit Care Med 34:559–561PubMedCrossRef

11.

Niël-Weise BS, Gastmeier P, Kola A, Vonberg RP, Wille JC, Van den Broek PJ, Head Bed Elevation Study Group (2011) An evidence-based recommendation on bed head elevation for mechanically ventilated patients. Crit Care 15:R111PubMedCrossRef

12.

Zanella A, Cressoni M, Epp M, Hoffmann V, Stylianou M (2012) The effects of tracheal orientation on the development of ventilator associated pneumonia: an experimental study. Intensive Care Med. doi: 10.1007/s00134-012-2495-2

13.

Marquette CH, Wermert D, Wallet F, Copin MC, Tonnel AB (1996) Characterization of an animal model of ventilator associated pneumonia. Chest 115:200–209CrossRef

14.

Panigada M, Berra L, Greco G, Stylianou M, Kolobow T (2003) Bacterial colonization of the respiratory tract following tracheal intubation-effect of gravity: an experimental study. Crit Care Med 31:729–737PubMedCrossRef

15.

Li Bassi G, Zanella A, Cressoni M, Stylianou M, Kolobow T (2008) Following tracheal intubation, mucus flow is reversed in the semirecumbent position: possible role in the pathogenesis of ventilator-associated pneumonia. Crit Care Med 36:518–525PubMedCrossRef

16.

Mauri T, Berra L, Kumwilaisak K, Pivi S, Ufberg JW, Kueppers F, Pesenti A, Bigatello LM (2010) Lateral-horizontal patient position and horizontal orientation of the endotracheal tube to prevent aspiration in adult surgical intensive care unit patients: a feasibility study. Respir Care 55:294–302PubMed

17.

Agbeko RS, Pearson S, Peters MJ, McNames J, Goldstein B (2011) Intracranial pressure and cerebral perfusion pressure responses to head elevation changes in pediatric traumatic brain injury. Pediatr Crit Care Med. doi: 10.1097/PCC.0b013e31820ac2ad

Title: Preventing ventilator-associated pneumonia: is it ultimately only a matter of gravity?
Author: Ioannis Pneumatikos
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 4/2012
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-012-2496-1

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Preventing ventilator-associated pneumonia: is it ultimately only a matter of gravity?

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