[Pharmacologic measures for the prevention of mechanical ventilation-associated pneumonia].
Ventilator associated pneumonia is the principal infectious complication in the Intensive Care Unit (ICU), and represents the main infectious cause of morbidity and mortality. Its diagnosis and management is complex. Consequently, its prevention becomes a cornerstone in daily clinical practice. Daily interruption of sedation, oral and digestive decontamination, prophylactic administration of systemic and/or inhaled antibiotics, glycemic control, stress ulcer prophylaxis, transfusion policy and timing and adequacy of antibiotic treatment are the main suggested pharmacologic interventions. The aim of this review is to critically describe the principal pharmacologic interventions for the prevention of ventilator associated pneumonia, focusing on the degree of the evidence and the appropriateness for daily clinical practice.
Ulldemolins
Marta
M
Servicio de Medicina Intensiva, Hospital Universitario de Tarragona Joan XXIII, Instituto de Investigación Sanitaria Pere Virgili (IISPV), Tarragona, Spain.
Restrepo
Marcos I
MI
Rello
Jordi
J
D000278:Administration, Buccal; D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007275:Injections, Intravenous; D009055:Mouth / Q000382:microbiology; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D013276:Stomach Ulcer / Q000517:prevention & control; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D006993:Hypnotics and Sedatives; D007004:Hypoglycemic Agents